The viscoelastic properties of some dental soft lining materials.

PhDThe viscoelastic properties of soft lining materials are of enormous interest and importance as they clearly govern the biomechanical function of these materials. Forced vibration (Non-resonant) dynamic mechanical analysis was used to characterise the viscoelastic properties of a wide range of commercial (8 brands) as well as experimental soft liners (7 formulations). Forced vibration DMA is the ideal way of studying these materials as it can closely and accurately mimic physiological temperatures and frequencies under which they operate. The materials were studied as processed, and subsequently after simulated ageing for time periods up to twelve months. The water absorption and the subsequent changes in the viscoelastic behaviour of these materials are important as they spend a large part of their working lifetime immersed in solution. The results, where possible, were compared with the work of other researchers, and any sources of discrepancy examined. It was noted that the materials whose glass to rubber transition (Tg) was near their operating temperature (i.e. the acrylics) were particularly prone to any changes in the time and temperature domain of the experiment. A large variation was observed in the properties of the commercial materials available. At 37°C and 1 Hz a seven fold range was seen in the real part of the modulus (2.79-19.7 MPa), and a fifty fold range was observed in the loss tangent (0.029-1.52). Given this wide disparity it is surprising that a universally recommended range of properties does not exist, although there is some speculation in the literature. The study of the ageing behaviour of these materials in water showed that the traditional hardening of the acrylics has been overcome. A heat cured silicone material was seen to be virtually unaffected by time, while for a cold cured competitor the opposite was true. New and experimental materials showed a wide range of behaviour after immersion in water

A Gadamerian approach to interpreting pain: model-making metaphors through embodied cognitive theory

This paper will discuss how the conceptualization of embodied, abstract notions such as pain, which is multi-modal, non-visual and subjective, has the potential to be communicated visually using model making, as it is traditionally understood in the fields of architecture and design. We propose a new methodological approach to research where Gadamer’s understanding of intersubjective interpretation (2004) used in conjunction with Simulation theory (Gallese and Goldman 1998) in embodied cognitive science, provides a strong framework in which to formulate a palette of materials and forms to visualize subjective experience. This novel approach to design research is currently being undertaken within the field of Health Sciences to produce metaphorically provocative, descriptive models of the lived experience of people with Rheumatoid Arthritis (RA) to help bridge the gap in understanding between the sufferer and the public. This paper seeks to engage briefly with two questions integral to the research being undertaken; how does one understand another’s pain, and how can one conceptualize and communicate abstract notions such as pain visually using material and form as language

Significant Walks

This paper will describe the trajectory of research between Thinking Path and Significant Walks and how the latter explores the reality of walking for individuals with chronic low back pain. Funded by the Wellcome Trust, Significant Walks pools the expertise of a research team that share a mutual interest in the resonance of walking as an interpretive tool and who came together following Shirley Chubb’s exhibition Thinking Path, which took Charles Darwin’s daily ritual of walking the same path in the grounds of his family home as its inspiration. The collaborative research team are working with a group of participants who are invited to identify a personal walk that encapsulates memory, reminiscence and familiarity as well as being a measure of their physical experience. Manifested as an immersive digital artwork, a methodology has been identified that synthesizes eye level video documentation of participant’s personal walks with simultaneously gathered streams of kinematic data recording the movement of the spine. Researchers and participants work together to explore how the interpretive qualities of visual effects can be applied to each body of synthesized footage in order to express the nature and resonance of personal movement whilst walking. Each micro journey expresses individual experience through the interpretation of clinically accurate data and acts as a vehicle for precise accounts of physical movement whilst also presenting the reflective individual at the core of scientific understanding

Significant Walks: Synthesizing Qualitative and Quantitative Reflections on Movement and Place

This paper will discuss how the Significant Walks project explores the impact of walking with chronic low back pain and considers how experience and reflection visualize the impact of this often overlooked condition. Funded by the Wellcome Trust, the project involved working with participants to investigate a regularly encountered personal walk as a measure of individual capability, physical experience and well-being. The use of digital technologies created a sense of presence by synthesizing point of view video documentation with simultaneously gathered biomechanical data recording the movement of the spine. Additional layers of interpretation were added to the synthesized footage as each participant explored how visual effects could express the issues they faced whilst walking. Driven by the biomechanical data the intensity of these effects results in a sequence of films that are simultaneously qualitative and quantitative with the challenge and reward of each walk creating highly personalized visual narratives that explore place and movement through acute visual detail. This paper will be accompanied by video extracts of participant walks showing how each micro journey interprets clinically accurate data whilst also expressing individual experience. The collaborative nature of the research situates reflective researchers and participants at the core of scientific understanding. In identifying how physical movement can reveal the intersection of quantitative knowledge and qualitative experience the research confirms that when we ‘seize “sensation”... we find ‘a formation already bound up with a larger whole, already endowed with a meaning.’ (Merleau-Ponty, M. (1996) Phenomenology of Perception. London: Routledge. Pg 9) http://significantwalks.com

"Significant walks": personal visualisations of the chronic low back pain experience-an arts, health and science project

Background: More than a third of the adult UK population are affected by low back pain, approximately 17 million people. The socio-economic cost is huge; the cost of healthcare alone is estimated to be £1.5 billion per year. However the personal cost is immeasurable. Back pain remains a hidden and misunderstood problem, with many sufferers finding it difficult to effectively communicate the pain and its devastating impact on their daily lives. "Significant Walks" was a collaborative project involving experts in the visual arts, health and science. The project explored the reality of walking for individuals with chronic low back pain and their personal visualisation of this experience. The aim was to deepen public and professional perceptions of the meaning for low back pain for those living with the condition. Purpose: The purpose of this project was to enable participants to express the nature of their experience of chronic low back pain by documenting a walk that is significant to them. Methods: Twelve participants suffering from chronic low back pain were invited to choose a personal walk of particular significance to them. The significance could be negative or it could be positive. Video recordings were collected during the walk using a head-mounted camera, giving "point of view" footage. Movement and acceleration data were simultaneously collected using external inertial sensors attached to the lumbar spine at L1 and S1 vertebrae. The inertial sensors captured the movement pattern, for example the rhythm of the walk, as well as the acceleration which occurred during the walking process. Pain levels were also monitored throughout the walk and qualitative data from each participant was gathered using a questionnaire format. The participants then used their own movement data to manipulate special effects applied to the original video and synchronised data creating hybrid footage that they felt represented their personal experience. Results: A visual representation of 12 significant walks has been co-produced by the researchers together with the participants. Key elements have been selected and combined in an immersive audio-visual exhibit. The exhibit demonstrates the interaction of the visual walk with spinal range of motion and acceleration data, pain levels and qualitative statements which express the individual's experience during their significant walk. Conclusion(s): The data has been consolidated into personal and valid expressions of the chronic low back pain experience. Implications: Implications are that collaborative working across Art, Health and Science disciplines and the use of visual arts and science can lead to powerful and significant visualisation of health experiences which has implications for the expression of a range of health topic areas which are usually invisible to the general public. Keywords: Art; Health; Chronic low back pain Funding acknowledgements: The project was funded by the Wellcome Trust, the University of Brighton and the University of Chichester. Ethics approval: Approved by University of Chichester Ethics Committee and FREG Committee, Faculty of Health and Social Science, University of Brighton

Capturing the experience of chronic low back pain through personal visualisations of significant walks an art and health project

Background: This study was developed from a collaboration between a musculoskeletal therapist and researcher, a fine artist, a media specialist and an engineer. All the team had an interest in Chronic Low Back Pain from a range of perspectives and shared a range of skills and knowledge which had never before been combined and utilised in this area of study. In context, Chronic Low Back Pain is an invisible problem that affects 80% of the UK population at some time in their lives. It is however a largely misunderstood which is an issue that individuals who experience it sometimes have difficulty communicating. Purpose: The purpose of the study was to capture participants' meaningful experiences of Chronic Low back pain in everyday life focusing on a personal significant walk. The aim of the project was to produce a series of visualisations with each of the participants which would enhance health professionals and members of the Publics understanding of the difficulties faced by individuals with chronic Low back pain. Methods: Twelve participants with Chronic Low Back Pain chose a walk of personal significance to them, either Positive or negative. Demographic data were collected at the start of the process as well as details regarding the extent and position of their pain.Prior to their walk Inertial sensors were attached to their Lumbar spine (L1-S1)and a head mounted video camera was fitted to their forehead to capture a video of their walk. Pain levels were monitored every 2 minutes during their 20 minute walk and qualitative data were collected prior to, during and after their walk using a range of approaches. Results: Using the data gathered, visual representationsof each of the significant walks have been co-produced by the researchers and the participants. Key elements of the video footage and data have been selectedand combined in a seriesof audio visual exhibitions. Each participant used their own movement data to manipulate special effects applied to the original video footage and data was synchronised to create hybrid footage that the participant felt represented their personal experience. Conclusion: Low Back Pain is a complex issue that creates significant personal challenges for those affected. This combined arts science and health approach to this work has demonstrated a range of outcomes that may be helpful in building a range of visualisations of a range of Musculoskeletal conditions. Implications: These very personal and valid expressions of Chronic Low Back Pain syndromes are now available for exhibition purposes. More public knowledge of the impact of Chronic Low Back Pain on individuals who experience the problem could create a greater understanding of the challenges faced by these people. The outcomes of the project will also be useful for teaching purposes in relation to health professional students. The more understanding members of the public and health professionals have of the personal impact of chronic low back pain the more likely it is that individuals with back pain will meet with more positive understanding from their family their friends and their colleagues. Funding acknowledgements: This Project was funded by The Welcome Trust in the UK Ethics approval: The research project was approved by the Un iversity of Brighton,Faculty of Health's Ethic and Governance committee Disclosure of interest: None Declared Keywords: Art and Health, Chronic low back pain, Patient experience

A randomised placebo-controlled study investigating the effects of mobilisation treatment duration on pain in participants with chronic low back pain

Background: A common treatment used by physiotherapists for patients with low back pain is mobilisation. The aim of applying mobilisation treatment is to increase range of movement and reduce pain and stiffness. Therapists choose a specific dose of mobilisation for each patient, which includes a decision on the duration of applied force, commonly up to 3minutes. Little research has been done to determine the effects of different durations of treatment. There is tentative evidence that increased duration beyond 3minutes leads to a decrease in pain. Purpose: This study aimed to establish the analgesic effects of short and long durations of lumbar mobilisation treatment. Methods: A randomised placebo controlled trial was conducted to establish the immediate and short-term (24hours after treatment) analgesic effects of different duration of lumbar mobilisation in participants with LBP. Comparisons of pressure pain threshold (PPT), verbal rating scale (VRS) of pain were made immediately after a placebo-control intervention and 2minutes of mobilisation treatment, and immediately and 24-hours after 1 and 6minutes of mobilisation treatment. Results: Analysis of treatment responders demonstrated that significantly more participants receiving longer duration of treatment experienced a reduction in PPT local to the site of treatment (p=.001). Overall, there was no significant difference between treatment groups. Verbal rating of pain on movement was significantly reduced after treatment (p<.01) but the difference between treatment groups did not reach significance. There was dissociation between participants’ verbal rating of pain and PPT. Treatment force had a significant mediating effect on pain (p=.01), with greater treatment forces resulting in greater pain reduction local to the site of treatment. Conclusion(s): This study highlighted the varying response of participants to lumbar mobilisation treatment. The difference is response levels and mediating effect of force on PPT were evident local to the site of treatment and not at more distant locations, suggesting that changes in PPT were mediated by a local analgesic mechanism. The dissociation between changes in PPT and verbal rating of pain imply these measures of pain are mediated by different underlying neurobiological mechanisms. Implications: These findings suggest that where pain allows, applying mobilisations for longer and with greater force may result in a greater analgesic effect. The dissociation between PPT and verbal ratings of pain in this study suggest that when investigating the analgesic effects of treatment, it may be important to incorporate a number of pain measures in order to gain wide appreciation of change in pain felt by patients

"Significant Walks" : Visualising Well-Being, Articulations of the Data and Experience of Chronic Low Back Pain

Authors Chubb, Shirley (1); Moore, Ann (2); Bryant, Neil (1); Saber-Sheikh, Kambiz (2)   Affiliations 1: University of Chichester, UK; 2: University of Brighton, UK   The "Significant Walks" project reveals the reality and positive impact of walking for individuals with chronic low back pain (LBP), a substantial but often invisible physical problem. Funded by the Wellcome Trust, the project brought together a collaborative research team of two visual artists, a musculoskeletal physiotherapy expert and a biomechanical engineer. Objectives: The project involved working with twelve participants with non-specific, chronic LBP who were invited to identify a regular necessary, or recreational walk that could be used as a measure of their physical experience and capability. Methodology: The research methodology records each walk by synthesizing point of view video documentation with simultaneously gathered biomechanical data collected via inertial sensors recording the movement of the participant’s spine. Additional layers of interpretation are added to the synthesized footage as the team worked with participants to explore personal narratives and how visual effects could further express the nature, challenge and reward of their chosen walk. The intensity of these effects was driven by the biomechanical data creating a sequence of films that are simultaneously qualitative and quantitative in the way that they interpret clinically accurate data whilst also expressing individual experience. Results: The project showed how digital technology enabled each participant to express the connection between walking and an awareness of personal well-being. Conclusions: By disseminating outcomes in arts and health related venues and contexts "Significant Walks" has raised awareness of the invisibility and commonality of LBP to a wider community whilst also promoting walking as an enabling and positive activity