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In a quest to design novel deployable structures, flexible polyhedra provide interesting insights. This work follows the discovery of flexible polyhedra and aims to make flexible polyhedra more useful. The dissertation describes how flexible polyhedra can be made. The flexible polyhedra first considered in this dissertation have a rotational degree of freedom. The range of this rotational movement is measured and maximised in this work by numerical maximisation. All polyhedra are established computationally: an iterative solution method is used to find vertex coordinates; several clash detecting methods are described to define whether each rotational position of a flexible polyhedron is physically possible; then a range of motion is defined between occurrences of clashes at the two ends; finally, an optimisation tool is used to maximise the range of motion. By using these tools, the range of motion of two types of simplest flexible polyhedra are maximised. The first type is a series of flexible polyhedra generalised from the Steffen flexible polyhedron. The range of motion of this type is improved to double that of Steffen’s original, from 27° to 59°. Another type of flexible polyhedron is expanded from a model provided by Tachi. Based on the understanding of Steffen’s flexible polyhedron, optimisation parameters are carefully given. This new type has achieved a wider range of motion, so now the range of motion of flexible polyhedron is tripled to 80°. After enlarging the range of motion of the degree of freedom in the 1-dof systems, the dissertation found multiple degrees of freedom in one polyhedron. The multiple mechanisms can be even repetitive, so that an n-dof polyhedron is found. A polyhedron of two degrees of freedom is first presented. Then, a unit cell for any number of mechanisms is found. As a repetitive structure, a 3-dof polyhedron is presented. Finally, this work presents the possibility of configuring a flexible polyhedral torus and a closed polyhedral surface that is able to flex without the need to stop.

Lumbar intervertebral disc disorder is a spinal condition that affects the normal function of the intervertebral discs mainly due to the natural aging process. This condition can manifest itself in pain and limited motion in the legs, amongst others. Posterolateral Fusion (PLF) and Posterior Lumbar Interbody Fusion (PLIF) are two of the most used surgical procedures for treating lumbar intervertebral disc disease. Although these procedures are commonly used and performed successfully the impact in terms of the stresses developed in the posterior implants employed and in the spinal components adjacent to the surgical site has not been exhaustively investigated. In addition, the consequences of the procedure on the reduction of the Range of Motion of the lumbar spine is not clearly understood. The objective of this research is to investigate the effect of one-level spinal fusion of lumbar segment L4-L5 on the stresses and the range of motion at the remaining, adjacent lumbar levels. Four 3 dimensional finite element models of a lumbosacral spine were created from Computer Tomography data (CT scan). The models were used to investigate four surgical scenarios, including the use of 0o and 4o interbody cages, in addition to the un-instrumented spine for flexion, extension, torsion and lateral bending motions. The predictions obtained from the models enabled the mechanical behaviour of the lumbar spine following fusion surgery using 0 o and 4o cages to be investigated and compared. In addition, a clinical study was performed to quantify the reduction in the range of motion for subjects who had undergone L4/5 posterior lumbar interbody fusion surgery. The clinical results were compared to those of subjects who had not undergone surgery and to the range of motion predictions from the computational model. The results from this research demonstrate that the insertion of posterior instrumentation does not have an impact on the spinal structures above the L3/4 intervertebral disc. However, the pedicle screws and the insertion of the interbody cages causes stress levels in the area adjacent to the surgical site to rise which could promote accelerated degeneration of the discs. Additionally, this study demonstrates how the pedicle screws are affected by the surgical spinal fusion techniques. Furthermore, the investigation demonstrates how posterior lumbar interbody fusion causes the range of motion of patients that had undergone this surgery to decrease. The results from the comparison of the behaviour of the use of 0º and 4º interbody cages in L4-5 posterolateral fusion demonstrates that the stress levels in the adjacent vertebrae, intervertebral discs and pedicle screw fixation system increase when 4º are used cages than when 0º cages were employed. The results from the in-vitro study show a decrease in the range of motion of the subjects who had undergone L4/5 posterior lumbar interbody fusion surgery when compared with the subjects with no low back pain history. This indicates that the PLIF surgery combined with the normal disc degeneration is subjected to higher stresses than the healthy spine.

Rotator cuff tears are a common cause of shoulder pain in the general community. Approximately one-third of patients with rotator cuff tears proceed to surgery following the failure of conservative treatments such as physiotherapy, non-steroidal anti- inflammatory drugs, opioid analgesics, and cortisone injections. However, rotator cuff tears continue to develop over time, and the burden of illness for patients awaiting rotator cuff repair is substantial, resulting in loss of strength, functional status, and poor quality of life. This dissertation proposes a three-stage approach for the management of rotator tears in patients awaiting surgery, which includes an accurate and reliable evaluation of shoulder range of motion (ROM) and strength, a pre-operative intervention to improve function and quality of life, and an appraisal of potential prognostic factors that can lead to better future clinical outcomes. Therefore, the organisation of this thesis is divided into three sections covering shoulder assessment, intervention, and prognosis. Chapter 1 introduces the concept of prehabilitation, a rapid systematic review, evidence gaps in the literature, and the rationale for shoulder prehabilitation. Prehabilitation is defined as enhancing a patient's functional ability before surgery to improve clinical outcomes following surgery. The rapid systematic review included only high-quality studies based on the National Health and Medical Research Council (Australia) evidence guidelines and the Physiotherapy Evidence Database (PEDro) rating scale. Only pre-operative exercise intervention studies for surgical knee and hip populations were identified. To date, no studies have investigated the efficacy of prehabilitation for patients scheduled for shoulder surgery. This finding necessitated a review of the considerable body of research on rotator cuff tears. Chapter 2 provides a synthesis of the current literature regarding shoulder anatomy, biomechanics of the rotator cuff, epidemiology, aetiology and classification of rotator cuff tears, shoulder assessment methods, an overview of management options, evidence for post-operative rehabilitation, and prognostic factors and potential predictors of outcome associated with rotator cuff surgery. Chapter 3 presents a published study examining the intra- and inter-rater reliability of a variety of testing protocols to measure ROM and strength in healthy participants. The objective measurement of ROM and strength is an integral part of the physical examination of patients with rotator cuff tears and is vital in quantifying improvement after conservative or surgical intervention. Correctly evaluating and interpreting objective shoulder measurements informs the clinical reasoning underlying treatment. Since pre- operative ROM and strength are potentially modifiable predictors for rotator cuff repair success, a precise assessment using reliable instruments and testing methods is essential. The outcomes of this study supported the selection of assessment methods for a randomised controlled trial (Chapter 7) on shoulder prehabilitation. Chapter 4 presents a published systematic review and meta-analysis on the reliability of the Kinect and ambulatory motion-tracking devices to measure shoulder ROM. According to our reliability study findings in Chapter 3, existing methods for evaluating shoulder ROM are less reliable. Emerging inertial sensor technologies and optical markerless motion-tracking systems are valid alternatives to standard ROM assessment methods. However, reliability must also be established before this technology can be used routinely in clinical settings. Chapter 5 presents a published validity and reliability study on the HumanTrak system to measure shoulder ROM in healthy subjects. Based on our findings in Chapter 4, we evaluated the clinical potential of using a movement analysis system that combines inertial sensors with the Microsoft Kinect (HumanTrak) to measure shoulder ROM reliably and accurately. Chapter 6 is a systematic review and meta-analysis of prehabilitation for the management of orthopaedic surgery. The initial rapid systematic review in Chapter 1 only identified orthopaedic prehabilitation programmes for patients undergoing lower limb joint arthroplasty, anterior cruciate ligament reconstruction, and spinal surgery. Given the growing research and clinical adoption of prehabilitation over the past decade, we undertook an updated and more comprehensive systematic review to identify and critically appraise the content and reporting of prehabilitation programmes for all orthopaedic surgeries. Exercise therapy is commonly first line treatment for older patients with non-traumatic rotator cuff tears. Despite growing evidence that exercise therapy and surgery can achieve comparable clinical outcomes, there is a paucity of high-quality studies on the impact of pre-operative exercise or education for patients awaiting rotator cuff surgery. Hence, the main aim of this thesis is to investigate the efficacy of a combined pre-operative exercise and education programme on function and quality of life before and after rotator cuff surgery. Chapter 7 is a randomised control trial (RCT) investigating whether the addition of a pre-operative exercise and education programme to usual care for patients awaiting rotator cuff surgery is more effective than usual care alone. Fifty patients with unilateral rotator cuff tears received either an 8-week shoulder exercise and education prehabilitation (SPrEE) programme or usual care (UC). The SPrEE programme compared to UC resulted in superior and statistically significant improvements in the primary outcomes of SPADI, WORC and SF-36 in the pre-operative phase. The SPrEE program was not more effective than UC alone in improving primary outcomes at 3-, 6- or 12 month follow-up timepoints. There were no statistically significant between-group differences in SPrEE and UC secondary outcomes for surgical or non-surgical patients. Chapter 8 investigated any correlations between pre-operative magnetic resonance imaging (MRI) characteristics and patient-reported outcome measures for patients who underwent rotator cuff repair or no surgery and received either prehabilitation or usual care in the RCT (Chapter 7). Prognosis-based prehabilitation can effectively identify patients who will derive the greatest benefit. Chapter 9 summarises thesis findings, strengths, and directions for future research to optimise function and quality of life prior to rotator cuff surgery.

Skeletal muscle is the primary organ for human movement. In this way, muscle is highly organized by architecture, fiber type, excitation-contraction coupling, and metabolism to supply energy, contract, and transmit force. When any of these aspects is disrupted, for example resulting from injury, there can be decreased force production capacity and impaired movement. Skeletal muscle is remarkable in its ability to repair, regenerate and adapt. Therefore, most injuries are recoverable. Though, in severe cases of muscle injury (i.e., volumetric muscle loss injury; VML), there is a permanent loss of function. For recoverable muscle injuries, rehabilitation improves recovery. However, rehabilitation remains minimally effective for VML injury and lacks physiologic rationale as to why. Preclinical models for rehabilitation of VML are limited and must expand to test a broader scope of rehabilitation variables (i.e., timing, type, intensity, and duration). One variable that may impact the response to rehabilitation is physical activity. Currently, extreme methods of activity restriction (i.e., hindlimb unloading, immobilization, and denervation) dominate activity restriction studies. Chapter one of this thesis is a review of the literature relating to skeletal muscle, skeletal muscle injury, physical rehabilitation, VML injury, and physical activity. The second chapter of this thesis evaluates a combined electrical stimulation and range of motion as a rehabilitation approach, and an underutilized model of restricting activity that limits housing space instead of completely unloading skeletal muscle. Collectively the data indicate that this rehabilitation impaired muscle function. Restricting activity recovered some impairment, suggesting restricted activity might improve response to rehabilitation. However, restricting activity also resulted in whole body metabolic impairment, a side effect that should be seriously considered if restricting activity is to be used as an adjuvant to enhance rehabilitation. Finally, chapter three dives into conclusions and future directions of this work. Future studies should be aimed at expanding the repertoire of rehabilitation models used for the rehabilitation of VML injury and explore other variables, particularly when to commence rehabilitation, what mode of rehabilitation might be best and most translatable, and how restricting activity may play a role.

Stretching is frequently used in an attempt to increase flexibility and enhance athletic performance. Stretching and similar techniques have also been used in sedentary and clinical populations to increase the mobility of joints, reduce pain and improve cardiovascular health. Yoga is not only a stretching exercise but uses a holistic approach that improves flexibility and incorporates mental awareness. However, yoga has seldom been investigated in elite athletes or a representative cross-section of society. In the first three studies of this research, a yoga intervention was employed to assess the influence of yoga on flexibility, balance, and sport performance (i.e. sprinting ability) in rugby players. Furthermore, in a fourth, large, cross-sectional study, I examined the effects of practising yoga on cardiovascular health markers (total cholesterol, blood glucose, heart-rate variability (HRV), and arterial stiffness) in healthy adults. Findings in the first study suggest that two, 1 hr yoga sessions per week for 12 weeks resulted in a significantly reduced postural sway signal in the 2-legged eyes closed antero-posterior (-109.7% ± 82.9) and medial-lateral (-115.5% ± 92.1, mean ± 95% CI, p 0.05). Players in the yoga group also significantly improved their 5 m sprint time -10.4 ± 10.2 (mean % change ± 95% CI, p < 0.05) compared to the control group 9.9 ± 6.1 (mean % change ± 95% CI, p > 0.05), suggesting that yoga may help female rugby players improve or at least maintain their sprint performance and flexibility during the season. Yoga has also been associated with health improvements, particularly for the cardiovascular system. In the fourth study, the associations between yoga and clinical measures of cardiovascular health was investigated in a large cross-sectional study. New Zealand adult participants were split into those that regularly practised yoga and those that did not. Overall, the regularly-practicing yoga participants had significantly lower carotid-femoral pulse wave velocity (-0.13 ± 0.28, m.s-1, p < 0.05, mean ± 95% CI) and systolic blood pressure (-2.0 ± 2.6, mmHg, p < 0.05), higher flexibility (12.7 ± 1.9 cm, p < 0.01), and higher total physical activity levels (1035.1 ± 671.3 METmin.week-1, p < 0.01) compared to the control group not practicing yoga. The control group was significantly taller (2.7 ± 1.7 cm, mean ± 95% CI, p < 0.002), heavier (8.2 ± 4.1 kg, p < 0.01), had more muscle mass (2.9 ± 1.5 kg, p < 0.05), higher body mass index (2.0 ± 0.7, p < 0.05), higher waist-hip-ratio (0.05 ± 0.02 cm, p < 0.01), and higher body fat (2.9 ± 3.1 kg) than the yoga group. Furthermore, the control group had higher blood glucose levels (92.0 ± 15.2 mg/dl) compared to the yoga group (90.6 ± 13.8 mg/dL, p = 0.36), but the yoga group had higher total cholesterol compared to the control group (192.1 ± 40.5 and 176.7 ± 42.8 mg/dL mean ± SD, for yoga group and control group respectively, p < 0.01). When the groups were separated into age categories the carotid-femoral pulse wave velocity was found to be significantly lower in younger (18 to 39 years) and older (60 years and above) yoga participants compared to controls. The findings suggest that regular practice of yoga is associated with reduced carotid-femoral pulse wave velocity and improved clinical measures of cardiovascular health. Overall, yoga appears to improve the flexibility of those who regularly practice it (i.e. 1 x per week) over a long time period (i.e. 3-months). In particular, yoga was found to be associated with improved eyes closed balance in rugby players and either maintained or improved 5 m sprint performance and improved some cardiovascular health indices among healthy adults. Overall, improved flexibility may be useful for daily physical functioning and for maintaining lifelong physical activity among the general population and for sport performance of athletes.

Motor vehicle crashes (MVC) are the leading cause of cervical spine (c-spine) injuries in children below 18 years of age. However, there have been reports of increasing injury trends around five year of age. In automotive safety, this age typically corresponds with a transition of child restraint systems: from a harnessed device to a booster seat which use the adult seatbelt. Anthropomorphic test devices (ATDs) and finite element modeling are commonly used to predict the biomechanical responses of pediatric occupants during MVC. However, a lack of experimental pediatric c-spine data results in the use of scaling techniques of adult male biomechanical responses to assess pediatric injury risks. These scaling techniques seldom represent the vast changes the c-spine undergoes from childhood to adulthood. Pediatric ATDs lack the ability to represent the nuances of growth and development of the pediatric c-spine and often result in poor biofidelity, or the ability to accurately predict and reproduce biomechanical responses of children. There is a need to understand the biomechanical response of the pediatric c-spine in a way that accounts for anatomical and developmental differences between children and adult males. Therefore, the objective of this study is to quantify the cervical spine range of motion, strength and stiffness of children 5–7 years old. A custom testing device was developed and validated to quantify pediatric c-spine strength and stiffness in the sagittal and coronal planes while range of motion (ROM) was quantified for all major planes of motion. Isometric strength was measured at a neutral neck position, 0° of axial deviation, and at mid-range of motion, 30° of axial deviation in each plane. During testing muscle activation was assessed and maximum voluntary isometric contractions (MVIC) were quantified for each participant. Dynamic concentric strength and stiffness values were quantified at a dynamic rate of 30°/s. Children had equal ROM in all planes of motion. Isometric strength was higher than dynamic strength, and higher at mid-range of motion compared to neutral position for both the sagittal and coronal planes. Active c-spine stiffness was higher than previously reported cadaveric stiffness values. Active pediatric c-spine stiffness was equal to those reported in computational modeling of pendulum testing. A lack of data of pediatric strength and stiffness data of non-symptomatic populations limited the comparisons between the current study and published works. The current study was expanded to include adult females such that the pediatric data could be compared to an adult group. Adult females were chosen as the relationship in size and strength between this group and children is more closely related than children and adult males. Strength and stiffness responses of the adults were scaled using traditional and novel scaling techniques to predict the responses of the pediatric population. The scaled responses were compared to the experimental pediatric data and the accuracy of each scaling method as a predictor was evaluated. Children had significantly increased ROM in the coronal plane compared to adult females. They were also weaker and less stiff in all evaluated metrics for both the sagittal and coronal planes. Scaling the adult response using traditional scaling methods did not result in an accurate prediction of strength. The use of novel scaling techniques using the adult females as a reference population were able to accurately predict strength and stiffness responses of the children. Whenever possible, adult females should be used as a scaling reference when predicting pediatric c-spine responses, though considerations of anatomical differences need to be considered to accurately predict kinetic responses.

This project began in partnership with the Inland Hospital occupational therapy department in Waterville, Maine. The therapists were interested in evidence on the effectiveness of instrument assisted soft-tissue mobilization (IASTM) as a therapeutic intervention for their patients. This technique is an alternative form of therapeutic massage, which uses metal instruments to treat soft-tissue adhesions. This project looked into therapeutic outcomes of IASTM for use on adults with physical dysfunction, specifically those experiencing pain or loss of range of motion. The project reviewed numerous studies on the topic of IASTM. Eleven articles were selected to be included in the final project based on highest level of evidence, relevant outcome measures, and use of IASTM tools. Findings suggest that IASTM gives relief from the signs and symptoms of carpal tunnel syndrome as well as low back pain in the long-term. Standard IASTM treatment times do not appear to be effective at improving muscular performance. IASTM appears to be effective at increasing peripheral blood flow to the area being treated. Several studies also demonstrate that IASTM is effective at decreasing pain and increasing musculoskeletal range of motion, although more evidence is needed to determine which specific diagnoses, treatment areas, and treatment strategies will result in the most beneficial clinical outcomes.

Abstract: Purpose: The aim of the study was to determine the feasibility of a combined therapeutic yoga and resistance exercise intervention for individuals with lung cancer and their caregivers Methods: A pilot feasibility study measuring recruitment rate, completion rate, intervention adherence and adverse events was conducted from May 2017 to December 2017. Participants and their caregivers were recruited from Cross Cancer Institute outpatient clinics and through self-referral. An 8-week intervention was conducted comprising therapeutic yoga and resistance exercise. The primary outcome for individuals with lung cancer was dyspnea. Secondary outcomes included quality of life, fatigue, chest expansion, muscular strength, pulmonary function and shoulder range of motion. The outcomes for caregivers were quality of life, fatigue and muscle strength. Post-study interviews were conducted to inform a future study. Results: The findings support feasibility with high recruitment and completion rates of 85% and 78% respectively. Adherence to the yoga and resistance intervention was 87%. There were no adverse events during testing or intervention sessions. For individuals with lung cancer, a significant difference was found from baseline to post-intervention in outcomes of dyspnea (p=0.01), fatigue (p=0.02), muscular strength (p

In this thesis research, we have explored the capabilities of a household body-tracking device - Microsoft Xbox Kinect for motion analysis and assessment to assist patient’s rehabilitation after joint replacement and repair surgeries. In particular, we have combined the motion tracking capabilities of Kinect with the 3D modelling of human body for accurate and intuitive movement assessment and feedback. Our prototype system demonstrates the effective and efficient workflow of motion capturing, data processing and analyzing and augmented reality based presentation, resulting in a design which is not only accurate, reliable and robust, but also extremely cost- and space-efficient. Furthermore, we have successfully developed a minimum viable commercial software assembling a portable motion lab that can be deployed conveniently at home, clinic office, physical therapy facilities, athlete training centers, or research institutes. We believe our system creates significant economic value for these potential customers by reducing the health care related cost, improving the rehabilitation outcome, and having the potential to prevent the excessive use of additive painkillers.

Knee osteoarthritis (KOA) is the primary cause of chronic immobility in populations over the age of 65. It is a joint degenerative disease in which the articular cartilage in the knee joint wears down over time, leading to symptoms of pain, instability, joint stiffness, and misalignment of the lower extremities. Without intervention, these symptoms gradually worsen over time, decreasing the overall knee range of motion (ROM) and ability to walk. Current clinical interventions include offloading braces, which mechanically realign the lower extremities to alleviate the pain experienced in the medial compartment of the knee joint. Though these braces have proven effective in pain management, studies have shown a significant decrease in knee ROM while using the brace. Concurrently, development of active exoskeletons for rehabilitative gait has increased within recent years in efforts to provide patients with a more effective intervention for dealing with KOA. Though some developed exoskeletons are promising in their efficacy of fostering gait therapy, these devices are heavy, tethered, difficult to control, unavailable to patients, or costly due to the number of complicated components used to manufacture the device. However, the idea that an active component can improve gait therapy for patients motivates this study. This study proposes the design of an adjustable lower extremity exoskeleton which features a single linear actuator adapted onto a commercially available offloading brace. This design hopes to provide patients with pain alleviation from the brace, while also actively driving the knee through flexion and extension. The design and execution of this exoskeleton was accomplished by 3D computer simulation, 3D CAD modeling, and rapid prototyping techniques. The exoskeleton features 3D printed, ABS plastic struts and supports to achieve successful adaptation of the linear actuator to the brace and an electromechanical system with a rechargeable operating capacity of 7 hours. Design validation was completed by running preliminary gait trials of neutral gait (without brace or exoskeleton), offloading brace, and exoskeleton to observe changes between the different gait scenarios. Results from this testing on a single subject show that there was an observed, significant decrease in average knee ROM in the offloading brace trials from the neutral trials and an observed, significant increase in average knee ROM in the exoskeleton trials when compared to the brace trials as hypothesized. Further evaluation must be completed on the clinical efficacy of this device with a larger, and clinically relevant sample size to assess knee ROM, pain while using the device, and overall comfort level. Further development of this design could focus on material assessment, cost analysis, and risk mitigation through failure mode analysis.

Floss bands have been used to improve ROM, restore joint mechanics, and break down adhesive tissue from previously injured musculature, however, there is limited research available and the few research studies have mixed results on the usefulness of floss bands. The purpose of this study was to investigate the effectiveness of floss bands in increasing elbow range of motion (ROM) in tennis players. Twelve elite tennis players (6 female and 6 male) participated in this randomized crossover design study. Subjects attended two separate sessions. Passive ROM measures were taken with a standard goniometer for elbow flexion and extension and forearm pronation and supination. For each session baseline ROM was initially taken. Subjects went into a separate room to have the intervention applied (floss band or no band) to ensure the author was blind to eliminate bias. After the intervention was applied ROM was re-measured. On their second visit, participants received the intervention that was not previously applied. A paired sample t-test revealed no significant difference (p > 0.05) between floss band and no band for all measures. This study is the first to investigate the use of floss bands to improve elbow ROM in elite level tennis players. The results show that floss bands are do not significantly improve elbow ROM compared to other treatment methods.

INTRODUCTION: Arthrofibrosis, which occurs in a substantial portion of the population, is a pathologic accumulation of scar tissue that presents in patients as a painful decrease in joint range of motion. Since an individual’s quality of life can be significantly impacted by arthrofibrosis and because there are limitations in current treatments, this thesis focuses on examining the use of the hormone relaxin to alleviate shoulder arthrofibrosis. METHODS: A set of 20 Sprague Dawley rats were given secondary shoulder contractures and separated into groups to examine the efficacy of relaxin using intravenous delivery, intra-articular delivery, and different treatment frequencies. The differences across groups were examined through mechanical range of motion testing as well as histologic sampling. RESULTS: Multiple doses of intra-articular injections of relaxin showed a complete return to the normal range of motion (P < 0.01) when compared with the surgical control, whereas other delivery methods and frequencies failed to show meaningful improvements. This was further confirmed in histologic analysis through the lack of fibrotic adhesions within the capsular space after multiple intra-articular relaxin treatments when compared with the surgical control. DISCUSSION: Although significant improvements to range of motion were seen after multiple doses of intra-articular relaxin, potential tissue degradation was also observed within the joint space after histologic examination. Further research is necessary to fully understand the proper dosing needed to avoid potential negative side effects caused by excess use of relaxin.

In this thesis, we have explored the use of the latest motion tracking technologies, as evident by Microsoft Xbox Kinect’s motion tracking capabilities, in combination with 3D digital human modeling and animation, multi-modality image capturing and processing, and fusion, to design a new generation of low-cost range of motion and gait analysis solutions that overcome the limitation of existing tools. The proposed solutions and our prototype systems have demonstrated accurate measurements and reliable analysis outcome compared to current clinic practices, with significantly reduced complexity and cost. Furthermore, it eliminates the need for expensive effort for pre- and post- processing of data, and also the need for a large lab space for placing the camera array. As a result, it is particularly suitable for deployment directly at doctor/therapist offices. Without having to send patient to the motion labs, which could be far away and expensive in most places, it gives them a tool to quickly and conveniently capture and access the range of motion and gait result for enhanced diagnosis, treatment, and rehabilitation for joint problems, e.g., for joint replacement and repair patients.Specifically, we have developed a touch-free solution for measuring the joint range of motion in the human body to address the clinic needs of evidence to support accurate diagnosis, treatment and rehabilitation for joint problems, and improvediiiinteraction and among patient, doctor, therapist and etc. In our approach, we will gather motion data captured through the motion tracking device Kinect and real- timely process motion data to obtain range of motion in enhanced accuracy and reproducibility. We have completed a prototype, which illustrates our entire work flow. Our preliminary experiment results have shown our system provides reliable and effective analysis of range of motions.We have also started the design and development of a Kinect-based gait analysis system to provide a broad range of high quality body motion analysis without having to depend on high cost equipment. We have completed all function components of the prototype and have use it to demonstrate the correctness, effectiveness and reliability of such an ultra-low cost solution in practice. Our preliminary experiments for feasibility study have shown consistent reproducibility and accuracy.In Summary, we have developed prototypes for range of motion and gait analysis, and have carried out experimental study to show their capabilities. We believe these new techniques will improve the current practice in clinical body motion analysis.

Purpose: The purpose of this study was to examine passive hip range of motion (ROM) and how it relates to countermovement jump height (CMJH) and peak power output (PPO). Methods: Twenty subjects (10 males, 10 females), 19-31 years of age (23.5 ± 3.0) participated in this study. Height (170.3 ± 6.9 cm), weight (65.8 ± 10.5 kg) and body fat (15.6 ± 6.9%, BodPod) were measured. Males with body fat greater than 17.5% and females greater than 27.5% were excluded from the study since jumping ability is limited by body fat. Power athletes were excluded from the study due to their likely jump training. Four passive hip ROMs were measured: flexion, extension, internal rotation (IR) and external rotation (ER). CMJH was measured using a Vertec vertical jump system. PPO was calculated using the Harman equation and then normalized for lean body mass (LBM). Subjects were categorized into groups for low, average and high ROM; those within one standard deviation (SD) of the mean were categorized into the average group; those below one SD of the mean were categorized into the low group; those above one SD of the mean were categorized into the high group. A Pearson correlation was used to determine the relationship between CMJH and PPO to hip ROMs. A one-way ANOVA was used to compare low, average and high ROM groups for CMJH and PPO. Results: There were significant (p < 0.05) negative correlations between hip flexion, extension and IR with CMJH (r = -0.67, -0.71, -0.64 respectively). While hip ER did not relate significantly (p > 0.05) to CMJH (r = 0.33), there was a significant relationship (p 0.05) differences in CMJH and PPO when low, average and high ROM groups were compared. Conclusion: Hip extension was associated with higher CMJH, while hip flexion and internal rotation associated with lower CMJH. Only hip external rotation correlated with PPO with a greater ROM associated with greater PPO. There is, however, no optimal ROM that relates to maximum CMJH or PPO. Flexibility should not be neglected however, as this may alter the alignment of joints and resting muscle length.

UCS is described as a muscle imbalance pattern located within the cervical and thoracic spine region. These imbalances have been shown to produce elevation and forward movement of the shoulders, winging of the scapula, and a forward extension of the head. These changes, in turn, lead to overstress of the cervical cranial junction and shoulders, which can cause neck and/or jaw pain, headaches, and shoulder problems. The purpose of this study was to determine if quantifiable differences existed in active range of motion, muscle strength and muscle endurance capacity between a group of patients with Upper Crossed Syndrome (UCS) and an asymptomatic group. A case-control experiment was completed. The case group consisted of 17 subjects with UCS, recruited through physical therapy and chiropractic clinics. The control group consisted of 17 healthy subjects, which were matched for age, gender and BMI on a group level. Isometric strength and endurance tests were completed. Neck range of motion was assessed about three axes. Significant differences in strength generating ability (neck flexion/extension, shoulder internal/external rotation, shoulder abduction/adduction) and range of motion (neck bending, neck rotation) were evident between the two groups. Endurance measures though, were comparable between groups. The results show that it is possible to use objective measures to distinguish between people with UCS and healthy controls, and thus demonstrate the possibility to move from a subjective to a quantitative objective diagnostic approach.

This study focuses on the design and implementation of a humanoid robot for disaster response. In particular, this thesis investigates the lower body design in detail with the upper body discussed at a higher level. The Tactical Hazardous Operations Robot (THOR) was designed to compete in the DARPA Robotics Challenge where it needs to complete tasks based on first-responder operations. These tasks, ranging from traversing rough terrain through driving a utility vehicle, suggest a versatile platform in a human sized form factor. A physical experiment of the proposed tasks generated a set of joint range of motions (RoM). Desired limb lengths were determined by comparing existing robots, the test subject in the experiment of proposed tasks, and an average human. Simulations using the desired RoM and limb lengths were used to calculate baseline joint torques. Based on the generated design constraints, THOR is a 34 degree of freedom humanoid that stands 1.78 [m] tall and weighs 65 [kg]. The 12 lower body joints are driven by series elastic linear actuators with multiple joints actuated in parallel. The parallel actuation mimics the human body, where multiple muscles pull on the same joint cooperatively. The legs retain high joint torques throughout their large RoM with some joints achieving torques as high as 289 [Nm]. The upper body uses traditional rotary actuators to drive the waist, arms, and head. The proprioceptive sensor selection was influenced by past experience on humanoid platforms, and perception sensors were selected to match the competition.

Adolescent idiopathic scoliosis is a three-dimensional spinal curve deformity that often requires surgery and instrumentation to correct. The Ponte osteotomy is a surgical resection technique used to realign the spine from a posterior-only approach, in an aim to better correct the spinal deformity. Less aggressive resection techniques such as facetectomy are currently being used in conjunction with posterior instrumentation systems. The goal of surgery is to achieve a stable, well-balanced spine by reducing the magnitude of the deformity and then fusing the spine in order to prevent curve progression. The biomechanical effects that are produced by these two techniques have not been evaluated previously. The current study implemented in vitro biomechanical flexibility tests in repeated measures fashion to determine differences in three-dimensional rotations achievable between (1) facetectomy and (2) Ponte osteotomy. Eight 56 to 87-years-old (mean = 72) cadaveric thoracolumbar multi-segment (T4-T10) specimens (six female, one male, one unrecorded) were used. A custom-built flexibility testing machine was used to apply 5 continuous cycles of pure bending moment to ± 4 Nm at a rate of 1°/s while allowing the motion of each specimen to remain unconstrained. Three separate pure bending moments were applied for each specimen, for 5 cycles, in the following directions: axial rotation (AR); lateral bending (LB); and flexion/extension (FE). An optoelectronic camera system (NDI Optotrak Certus) was used to capture the 3D kinematics of T9, T8, T7, T6, T5, and T4. The load-displacement data collected during the last loading cycle were analyzed to determine the range of motion (ROM) achieved by the intact spinal column. The tests were repeated and analyzed after facetectomy and again after Ponte osteotomy.Significant differences were found in the overall multi-segment ROM after Ponte osteotomy, compared to the ROM increase after facetectomy alone. Single factor ANOVA tests showed significant overall multi-segment ROM increase in the directions of: FE (p=0.0001), and AR (p=0.005); with a 95% confidence interval (a=0.05). In FE, ROM increased from 116% (of intact) after facetectomy, to 161% (of intact) after Ponte osteotomy. In AR, ROM increased from 116% (of intact) after facetectomy, to 143% (of intact) after Ponte osteotomy. The overall multi-segment ROM increase in LB was not statistically significant for the two surgical states. Inter-segmental ROM increases were significant in some, but not all of the spinal segments, and were found using the same statistical analyses.The current study showed that, while facetectomy increased ROM in all three directions, Ponte osteotomy produced a significantly greater increase in ROM in FE and AR over facetectomy when compared to the intact state. These preoperative and postoperative kinematics results may be used to quantify the spinal deformity correction angles achievable with each posterior resection technique. The appropriate clinical judgment can then be made, in deciding the correct surgical procedure for a given spinal deformity. The deformity correction angle that needs to be achieved surgically should be compared against expected correction angle values, in order to choose the procedure with the smallest possible associated risk factors.

The primary purpose of this research study was to identify significant relationships among measures of ankle strength, ankle range of motion, body composition, and functional capacity to balance ability in geriatric populations which may potentially assist in identifying older individuals with increased risk of falling. A battery of five test (ankle strength assessments, ankle range of motion , DXA, functional fitness, and balance) were administered to 20 participants (6 males, 14 females, mean age 69.78 ± 3.98) that had indicated to be at least 65 years of age or older and no history of falls within the previous 12 months. Results demonstrated that no significant statistical relationships exist between functional components (R2 = .240, Part2 = .11, p = .358), relative strength (R2 = .240, Part2 = .09, p = .358), range of motion (R2 = .240, Part2 = .00, p = .358) and body composition (R2 = .240, Part2 = .07, p = .358) as each relates to balance. Additionally, the data failed to demonstrate any significant relationship of relative ankle strength (R2 = .19, Part2 = .08, p = .221) and ankle range of motion (R2 = .10, Part2 = .08, p = .221) as compared to functional capacity. Although the data failed to demonstrate statistical significance or strong correlations, the individual components effect on balance may be more appropriately observed when combined with more complex indicators of fall risk such as gait analysis or biomechanical measures in dynamic balance conditions.

Shoulder injuries are associated with tightness of posterior shoulder tissues. Posterior shoulder tightness is currently evaluated by using two measures of shoulder joint range of motion, internal rotation with the shoulder abducted to 90°, or horizontal adduction with the shoulder flexed to 90°. The range of motion in these measurements is influenced by tightness in the posterior capsule and/or posterior muscles, and is also impacted by the magnitude of humeral torsion. The inability to identify the specific structure responsible for range of motion loss using these measurements affects the planning and outcome of conservative treatments aimed at regaining range of motion. The aim of this project was to evaluate current and potential measurements of posterior shoulder tightness so that separate measurements of glenohumeral joint posterior capsule and posterior muscles can be identified. Another aim was to evaluate the validity of palpation of bicipital tuberosities for measuring humeral torsion. To evaluate the effects of glenohumeral joint (GHJ) posterior capsule contracture on range of motion, a cadaver study was conducted. The purpose of the study was to identify a range of motion measurement sensitive to changes in the GHJ posterior capsule length. Repeated measures of shoulder ROM across four posterior shoulder tightness measurements were performed before and after experimental capsular contracture. Maximum reductions in the range of motion were observed in measurements that combined shoulder flexion and internal rotation.To evaluate the effects of posterior muscle extensibility on the range of motion, an in-vivo study was conducted. Repeated measures of shoulder range of motion across four posterior shoulder tightness measurements were performed before, immediately after, at 24 hours, and at 48 hours after repeated eccentric exercises of Infraspinatus and Teres minor. To verify the effect of eccentric exercise, Infraspinatus and Teres minor hardness were also measured at the same time as the range of motion measurements. Maximum reduction in the range of motion was observed in a measurement that combined shoulder extension and internal rotation. Infraspinatus hardness was observed to increase immediately after repeated eccentric exercise. To evaluate the validity of using palpation of bicipital tuberosities for measuring humeral torsion, an in-vivo study was conducted. The bicipital-forearm angle, an indirect measure of humeral torsion, was measured using palpation of bicipital tuberosities and real-time ultrasound imaging. Agreement among the two methods was excellent with the intraclass correlation coefficient = 0.92. The findings of these studies taken together suggest using a progressive approach to test posterior shoulder tightness. The first step should be the comparison of humeral torsion between the dominant and non- dominant shoulders. If between shoulder range of motion differences are greater than between shoulder humeral torsion differences, posterior capsule and muscle should then be evaluated. The posterior capsule may be best evaluated in a position of shoulder joint flexion and internal rotation, while for evaluating posterior muscles a position of shoulder joint extension may be used.

The objective of this investigation is to determine the optimum positions of the prosthesis in total hip arthroplasty that produce least amount of impingement. Theoretical ranges of six basic hip motions were determined under walking, stumbling, internal rotation at 90 flexion and external rotation at 0 extension with 15 abduction, using mathematical models and validated for impingement using finite element analysis. A generalized approach, where impingement does not occur, was developed in this study to understand influence of design parameters such as head-neck ratio, neck-shaft angle, oscillation angle, and stem offset on cup-stem orientations such as cup inclination, cup anteversion, and stem antetorsion. Stems with head-neck ratio lower than 2.3 and neck shaft angle greater than 135 did not impinge. For impingement free range of motion, cups should be anteverted more when stems with high neck shaft angle are combined with low stem offset and antetorsion.

Abstract: Elbow contractures in burn survivors lead to difficulties in their ability to perform meaningful occupations. Interventions focus on improving movement at the elbow while considering social and psychological factors in the individual's environmental context. The purpose of the review was to determine the methodological quality of research evaluating splinting and serial casting to improve elbow contractures and resulting functional limitations. A comprehensive search strategy uncovered 10 research studies. Standardized critical appraisal tools and protocols were used to analyze the research. Although some methodological issues were identified, the findings were positive. Strengths and weaknesses of the research were delineated to support and guide the use of serial casting and splinting. A body of research was found to warrant consideration of social and psychological factors. Conclusion. There is preliminary quality of evidence to support the use of splinting and serial casting and important considerations for future research.

A biomechanical study was performed to compare range of motion of the multi-body lumbar spine using three different protocols: pure moment, eccentric loading, and a new method called combined loading moment. The objectives of the study were to introduce a new protocol that overcomes the limitations of previous methods by applying more realistic loading conditions and to compare the range of motion of this new protocol to those of eccentric loading and pure moment protocols within the same specimen pool. The second objective of this study was to compare the data sets of these three protocols to both in vivo and in vitro data sets. Because of the clinical issues with the lumbar region of the spine, it is important to understand the normal mechanics of the lumbar spine. In vivo methods of determining normal mechanics are limited, and in vitro methods have shown to be more realistic. Pure moment methods apply only a pure moment that is constant at every level of the spine. Pure moment with the addition of follower load increases the load carrying capacity of the in vitro spine. Eccentric loading produces physiological motion but the moment loads applied at each level are unknown. The previous methods of loading do not account for shear loads applied in vivo. A new method was developed called combined loading moment and includes axial, shear, and moment loading. This study compared three methods using six harvested spines tested in flexion and extension. Eccentric loading was first applied using an existing protocol of the University of Tennessee Health Science Center (UTHSC) Joint Implant Biomechanics Laboratory. Pure moment and combined loading moment were both applied using new protocols adapted from pure moment for single motion segment units using the UTHSC Spine Robot. The intersegmental rotations were measured using a camera system with LEDs. These rotations were used to create motion profiles to compare to in vivo studies and previous in vitro studies. Variations among in vivo and in vitro motion profiles could be due to a number of factors including subject groups and test methods. Results from this study showed that follower load may not be necessary in order to apply in vivo loads to the in vitro spine. Axial load was determined to limit range of motion. Shear loads appeared to increase flexion range of motion, but appeared to only increase extension range of motion until the facets joints prevented further motion. The pure moment protocol used with the Spine Robot overcame the limitations of standard fixed pulley methods of pure moment. Future work with the new protocol should attempt to increase the magnitude of the vertical load and further explore the effects of shear load. Additionally, future work should include lateral, axial, and coupled rotations.

The purpose of this dissertation was to analyze shoulder joint kinematics and electromyographic activities of wheelchair propulsion between two stroke patterns. Twenty physical therapy students (14 females and 6 males, age 27.4 ± 5.9 years, body mass 64.41 ± 9.37 Kg and body height 169.32 ± 9.12 cm) participated. Eleven reflective markers were placed on thorax and right scapula, humerus, third metacarpophalangeal joint and wheelchair axle. Surface electrodes were placed on right pectoralis major, anterior and posterior deltoids, infraspinatus, middle trapezius, biceps brachialis long head and triceps brachialis. Participants propelled a standard wheelchair on a stationary roller system at 0.9 m/s and 1.8 m/s with semicircular (SC) and single loop (SL) stroke patterns for 20 seconds. Three-dimensional body movement and muscle activities were recorded at 100 and 1000 Hz, respectively. All data were compared for differences between two patterns and two speeds using 2-way repeated measures ANOVA (α < .05). Results showed longer drive phase and shorter recovery phase in SC when compared to SL, with no difference found on cycle time. Smaller release angles in SC caused longer angle ranges of hand contact on the pushrim while initial contact angles did not change. During drive phase, smaller scapular protraction range of motion (ROM) was found in SC. Shoulder abduction in drive phase was larger in terms of the maximal angle and ROM. In the recovery phase, minimal scapular tilting, protraction, and shoulder abduction and internal rotation were larger in SC when compared to SL pattern. Shoulder linear velocities and accelerations were higher in both phases for abduction/adduction and flexion/extension in SC. For SC pattern, pectorals major and middle trapezius showed lower activities during drive phase while posterior deltoid and triceps showed higher activities during both phases when compared to SL. Although posterior deltoid and triceps muscles work harder in SC pattern, longer drive phase and lower muscle activities in pectorals major and middle trapezius during the drive phase may make SC the better stroke pattern in wheelchair propulsion when compared to SL.

Fusion has been the gold standard treatment for treating the disc degeneration. Fusion surgeries restrict the motion at the implanted level there by imposing additional load at the adjacent levels. Many clinical studies have showed that adjacent segment degeneration was observed in patients over time. In order to overcome problems with fusion devices, dynamic stabilization systems are being used to treat disc degeneration related problems. These implants restore intersegmental motion across the implanted level with minimal effects on the adjacent levels. In vitro cadaveric testing was conducted on seven harvested sheep spines using established protocols. Axient was implanted in the spines 3 months prior to sacrificing. Main aim of this testing is to see if the performance is altered by the presence of surrounding muscle tissue. The specimens were prepared and tested under load control protocol. All six loading modes were tested by applying a pure moment of 10Nm (in steps of 2.5Nm) and angular displacement was calculated for the following cases: 1) Intact spine + Axient with surrounding muscle tissue, 2) Intact spine + Axient with muscle tissue removed, 3) Intact spine (with implant removed). Relative motion of L4 vertebra with respect to L5 was calculated. Statistical analysis was performed (on the implanted level data) to see if there is a statistical significance between cases 1 and 2. Biomechanical testing was also performed on 4 human cadavers to observe the trend with Axient compared to FE results. A validated 3-D non linear finite element model of the L3-S1 lumbar spine was used to evaluate biomechanics of various dynamic stabilization systems in comparison with traditional rigid rod system. The model was modified at L4-L5 level to simulate three different dynamic stabilization systems (DSFM-1, DSFM-2 and Axient, Innovative Spinal Technologies Inc., Mansfield, MA). Grade I was simulated at L4-L5 level. Follower preload of 400N and a 10Nm bending moment was applied to simulate physiological flexion, extension, lateral bending and axial rotation. Range of motion (ROM), intra discal pressure (IDP) and facet loads were calculated for all the models. Implant with better performance was then compared with fusion system in both grade I and grade II degenerated spines.In vitro results showed that there is no significant difference in the performance of the Axient with and without surrounding muscle tissue in terms of range of motion. Coming to FE results, Axient performed better over the other two implants (DSFM-1 and DSFM-2). Axient device was able to restore the motion at the implanted level compared to fusion device. Higher motions were observed at the adjacent level (L5-S1) with fusion device compared to intact and injured models. Both devices were able to stabilize the diseased spine and unload the treated disc.

The main goal of this research is to characterize the obese population based on anthropometry and range of motion (RoM) data collected from a sample taken from the University of Cincinnati community and to give the design implications of the corresponding characteristics. The anthropometric and RoM data consisted of 40 anthropometric dimensions collected from 20 male obese individuals and 20 male non- obese individuals. The body mass index (BMI) of the obese individuals was over 40 kg/m2 and the BMI of the non-obese individuals was between 20 kg/m2 and 25 kg/m2. The descriptive statistics for the 40 anthropometric dimensions and 33 RoM parameters were calculated for the two sets of population and they were tested for difference in means statistically. The difference in variance for different parameters was also tested for the two different populations. It was identified that the means of several anthropometric measurements and certain RoM measurements were significantly different between the two populations and the same was true in the case of variances. These differences represented several changes in design considerations which have been explained in detail. On comparison of the sampled obese population data with the US civilian population data that is currently used for design purposes, it was found that majority of the obese population is left out in our quest to provide an ergonomic environment thus stressing on the urgent need for such kind of research.

Stretching routines are typically integrated into exercise programs to improve flexibility and performance. Static stretching has been promoted as the safest and best method of stretching whereas the very different ballistic method of stretching has been virtually abandoned due to its associated risk of injury. The purpose of the current investigation was to examine the biomechanics and muscle activity associated with static and ballistic stretching of the hamstring muscles in order to compare the assets and liabilities of each technique. In a randomized cross-over design, 16 men and 13 women (22.5 ± 4.5 yrs) participated in both static (STA) and ballistic (BAL) conditions. Each condition required the subject to perform a pre-maximum stretch, a series of three 30-second static or ballistic stretches, and a post-maximum stretch. Electromyography (EMG) of the gluteus maximus, hamstrings, gastrocnemius, and rectus femoris muscles as well as joint kinematics were measured during all procedures. Data regarding maximum stretch distance and hip angle were recorded. Measurements of perceived soreness were made before and after the stretching exercise as well as at 24, 48 and 72 hours after stretching. A two-way repeated measures ANOVA was used for statistical analysis of perceived soreness, maximum stretched distance, and hip angle and t-tests were used for analysis of muscle activity. Significance was determined at the p < 0.05 level. Stretching exercise significantly increased maximum distance stretched and hip flexion (p < 0.05), however there was no difference between the stretching techniques. No significant effects for muscle activity or soreness were found between the static and ballistic conditions. In conclusion, static and ballistic stretching influence range of motion, hip angle, muscle activity, and soreness similarly and, thus, contraindications towards ballistic stretching may be unwarranted. Future research should investigate whether differences exist in the kinematics and muscle activity patterns of the actual static and ballistic stretching maneuvers.

Seated reach capability is limited by the strength, range of motion, and balance capabilities of the individual. In forward reaches people are able to maintain balance by generating forces and torques at their hips, supporting themselves over their legs. In contrast, lateral reaches, particularly those in which torso motion is required, are frequently limited by balance. A model-based study and two experiments involving human participants investigated the effect of task characteristics (motion duration, torso recruitment, and hand load) on the differences in static and dynamic analyses and the magnitude of the center of pressure excursion. The results indicate that static, terminal posture analysis is sufficient for evaluation of most seated tasks. An additional experiment used center of pressure excursion measurement to quantify the balance-maintenance capability of thirty-eight adults ranging in age from 21 to 74 years. While the excursion capability decreased with age when a handle was not used, the use of a handle by the contralateral hand allowed older participants to produce lateral excursions similar to those of the younger participants. Three examples of how the results of this dissertation can be applied are presented. The first demonstrates how motion and postural prediction can be affected by integration of balance considerations. In the second, balance prediction and the capability estimates are used in the design of a vehicle environment. The third is an evaluation of the forward-reaching motions and strategies of people with spinal cord injury.

To assess the effect of injury to the ankle on postural sway in participants with a history of no injuries, one injury and two or more injuries. To compare the changes in passive range of motion of the ankle in participants with no injuries, one injury and two or more injuries. The results suggest that there are some changes in inversion range of motion and some deficits in proprioception once an ankle injury has occurred. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

Muscle energy technique (MET) has been advocated for the treatment of restricted range of motion in the upper neck. However, there is little evidence to determine the effectiveness of MET on the optimal duration of isometric contraction during the technique. The aim of this study was to investigate the effect of various durations of MET isometric contractions on active atlanto-axial rotation range of motion. 52 asymptomatic subjects (age 18-43) who displayed a unilateral active atlanto-axial rotation asymmetry of 4 degree or more were randomly allocated to either a 5 (n=17) or 20 second (n=18) isometric contraction MET group, or a sham (n=17) treatment control group. Active atlanto-axial end range measurements were recorded pre and post-intervention, and the examiner was blinded to group allocation. Analysis with a one-way ANOVA revealed significant differences (p=0.04) in the mean change between the 5-second MET group and the control, but not between the 20-second MET group and control. MET using 5-second contractions produced the largest mean increase in rotation, both to the restricted (+6.65 degrees) and non-restricted sides (+0.71 degrees). The 5-second MET produced a large effect size (d=1.01), whereas the 20-second MET (d=0.68) and control (d=0.33) produced medium and small effects. This study failed to demonstrate a significant benefit in the use of a longer (20-second) isometric contraction when treating the upper cervical spine with MET. The use of a 5-second isometric contraction appeared to be more effective than longer contraction durations for increasing cervical range with MET, but further investigation is recommended. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

NOTE: Unpublished paper. SIRC research award. Includes bibliographical references. [ABSTRACT FROM CONTRIBUTOR]

The purpose of this study was to investigate the effects Therapeutic Touch had on pain and range of motion (ROM) associated with delayed onset muscle soreness (DOMS). Thirty four female subjects from physical education classes at Georgia Southern University volunteered for this single blind study. Each subject read and signed an informed consent form and completed a pre-participation questionnaire prior to their participation in the investigation. DOMS was induced in the non-dominate biceps of all subjects via eccentric biceps curls. Subjects were then randomly assigned to one of three groups. Group I was the control group which received a mimicked therapeutic touch treatment. Group II received therapeutic touch treatment 24 hours after delayed onset muscle soreness was induced, and Group III received therapeutic touch treatment immediately after DOMS was induced. Baseline pain and ROM measurements were obtained before DOMS was induced. Pain and ROM measurements were followed for 24, and 48 hours after DOMS was induced, and after treatments. The alpha level was set at p