Saudi Cultural Missions Theses & Dissertations
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Item Restricted Effect of Light and Heavy Touch on Transtibial Amputees’ Postural Control and Weight-Bearing Asymmetry(University of Illinois Chicago, 2024) Tobaigy, Moaz; Sawers, AndrewThe objective of this thesis was to determine the effect of augmented sensory feedback and mechanical support on traumatic unilateral transtibial prosthesis users’ postural stability, neuromuscular control, and weight-bearing asymmetry during quiet stance. Our central hypothesis was that postural instability in traumatic unilateral transtibial prosthesis users is a sensory problem. To test this hypothesis 12 traumatic unilateral transtibial prosthesis users and 12 unimpaired age- and sex-matched adults were recruited, enrolled, and completed the study protocol. Participants postural stability, neuromuscular control, and weight-bearing asymmetry were assessed during quiet stance under three conditions: baseline no touch, light touch, which provides sensory feedback, and heavy touch, which provides mechanical support. Postural stability, neuromuscular control, and weight-bearing asymmetry were characterized by center of pressure mean velocity, total integrated area across select lower limb muscles, and a weight-bearing asymmetry index, respectively. In the first study of this thesis unilateral transtibial prosthesis users were found to have greater medial-lateral but not anterior-postural postural instability than age- and sex-matched adults. Importantly, this medial-lateral instability was only resolved relative to age- and sex-matched adults with mechanical support from heavy touch. In the second study we found that neither light touch (i.e., sensory) nor heavy touch (i.e., mechanical support) shifted traumatic unilateral transtibial prosthesis users’ neuromuscular control of postural stability towards proximal muscles during quiet stance. In contrast, we found that mechanical support from heavy touch significantly reduced the total muscle activity used by traumatic unilateral transtibial prosthesis users during quiet stance. In the third study of this thesis we found that despite improvements in postural stability via heavy touch, there was no accompanying reduction in weight-bearing asymmetry, suggesting that weight-bearing asymmetry is not used as a compensation to maintain stability The results of this thesis suggest that contrary to our central hypothesis postural instability in unilateral transtibial prosthesis users may be attributable to mechanical rather than sensory deficits.17 0Item Restricted The effect of dual task training on postural control of young and older adults(Loughborough University, 2024-03) Alqurafi, Alaa; Blenkinsop, Glen; Pain, MatthewResearch has shown that a lack of postural control during standing, particularly a failure to use the reactive balance strategy to regain equilibrium, is a leading cause of falls for older individuals. However, most previous fall prevention research has focused solely on the motor aspect of the balance system while ignoring cognitive influence. Thus, the current thesis highlights and provides novel evidence by addressing essential gaps and limitations in the literature related to dual task assessment and training and how they influence postural control in different age ranges. This thesis aimed to examine the effect of novel dual task training on different age groups postural control and dual task cost. In order to achieve this aim, three studies were conducted. The first study was a systematic review and meta-analysis aimed at reviewing the effect of a specific or general exergame DT training on postural control among older adults over 65 (Chapter 3). Both DT training has been shown to enhance cognitive, balance, and dual task performance in most of the studies. The study concluded no significant difference between the specific and general exergame training for these performances. The other two studies were conducted to measure the effect of novel interventions on young and older adults (Chapters 5 and 6). Both studies were a quasi-experimental design with pre-and post-testing. The studies compared two types of DT training with different goals: Cognitive Dual task Training (CDT) and Balance Dual task Training (BDT). Both DT training were unsupervised and used exergames three times a week for two months. The BDT focused on training and enhancing the ankle strategy. In contrast, CDT aimed to improve specific cognitive domains such as working memory, reaction time, mental tracking and decision-making under the dual task paradigm. These studies found that the BDT was more effective in enhancing hand reaching activity, balance stability and limit (LOS) of stability in young and older adults. Conversely, the CDT group showed better cognitive task outcomes for both younger and older participants. Also, BDT resulted in an overall reduction in dual task cost in static balance and LOS for younger and older participants, respectively. In contrast, CDT resulted in an overall increase in DTC. In addition, CDT and BDT decreased walking time in Time Up and Go test by 0.5 seconds, indicating that DT training assisted to reduce the walking time factor of risk of falls among older adults over 65.Finally, both DT training showed a high adherence rate of over 93% of training sessions among young and older participants. In conclusion, completing the current thesis has resulted in new knowledge about the effect of different types of DT training on individual responses to dual task elements (i.e. a cognitive or balance task) and postural control. In addition, selecting a proper assessment tool can help objectively measure DT training’s influence on postural control. Using unsupervised exergame DT training is feasible to reduce the risk factors for falls among older adults.12 0Item Restricted THE BIOMECHANICAL EFFECTS OF CROSS-LEGGED SITTING ON THE LOWER LIMBS AND THEIR IMPLICATIONS FOR REHABILITATION(University of Dundee, 2024-02-01) Alsirhani, Hadeel; Wang , Weijie; Arnold, GrahamProject Title: The biomechanical effects of cross-legged sitting on the lower limbs and their implications for rehabilitation. Background: Balanced coordination between several body parts could play a significant role in protecting these body parts from injury and the body posture from deformities, particularly during the sitting position, as sitting constitutes more than half of people’s daily activities. Although the cross-legged sitting posture is widely practiced as part of the daily routine in certain communities, limited research is focused on the effects of CLS on biomechanics. Therefore, the aim of this study was to analyze the biomechanical effects of cross-legged sitting on the lower limb joints and muscles and investigate the effect of CLS on body balance. Methods: Thirty healthy volunteers were invited to participate in this study: 15 males and 15 females. Cross-legged sitting (CLS) was analysed biomechanically by comparing the situation before and after 20 minutes of CLS, based on temporospatial measures, kinetic and kinematic parameters, muscular electrical activity, muscular strength, and a static and dynamic balance assessment. The instruments used were the Vicon motion capture system with a combination of the force platform, Electromyography, Force sensor, the single-leg stance test, and the four-square step test. The variables were analysed using SPSS® version 28. Results: CLS can affect the gait’s temporospatial parameters positively by increasing the cadence, increasing the walking speed, and decreasing the stride and step time. In addition, the kinematic ROM for all the lower limb joints increased post-CLS compared to pre-CLS in all planes except for the knee sagittal ROM, which decreased significantly following CLS. Considering the kinetic parameters, the medial and lateral forces increased significantly in terms of RoF during walking post-CLS compared to pre-CLS xviii in almost all of the lower limb joints, including the hip, knee, and ankle on both sides. Moreover, the left knee and right ankle joints were similar in terms of an increased anterior force post-CLS, while the posterior force was increased in both sides of the hip joints and decreased significantly in only the left ankle. Furthermore, the compression force increased significantly on both sides of almost all of the lower limb joints except for the right knee, while the tension force improved noticeably on only the right hip, left hip, and left knee joint. When comparing walking pre-CLS with post-CLS according to the moment values, it was observed that the flexion/extension moment rose significantly post-CLS in the hip and knee joints in terms of ROM, while only the plantar flexion moment increased in the right ankle during walking post-CLS compared to pre-CLS. However, it was noticed that only the left leg displayed a significant increase in the knee valgus moment, as well as the hip and ankle abduction moment. Regarding the rotation direction, the left knee displayed a significant decline in terms of the internal/external rotational moment. Regarding the power values of all of the lower extremity joints, it was found that all of the hip, knee, and ankle joints were similar in terms of displaying increased RoP during the gait after 20 min of CLS compared to before. Regarding muscular electrical activity and muscular strength, only the lateral gastrocnemius muscle was activated significantly post-CLS. In the case of muscle strength, the hip extensor and knee flexor muscles became significantly stronger (by approximately 14%) post-CLS compared to pre-CLS roughly and the ankle plantar flexor’s maximum force increased noticeably, by about 4%, post-CLS. Regarding balance, CLS had a positive impact on the dynamic balance, while the static balance was affected negatively post-CLS compared to pre-CLS. Conclusion: CLS has a positive impact on all of the lower limb joints and muscles apart from the knee Flexion/Extension angle and Internal/External rotational moments. Depending on the muscular results, CLS can be safely included in people’s daily routine xix and in any rehabilitation programmes to improve the muscular strength that is responsible for hip extension, knee flexion and ankle plantar flexion, and increase the range of motion accordingly. However, CLS should be avoided for any patients suffering from static balance disturbance.51 0