All the fatigue tests were performed at the 10 Hz frequency, the stress cycle being a symmetrical alternating one, with the asymmetry coefficient R = -1, the cycle stress being that of tension compression one. For the three sets of fatigue specimens for D sample, with and without reconditioning techniques applied, three durability curve was drawn and then compared. For tracing the durability curves, two variations of the force were applied to the fatigue test specimens of the sample D ( and the third between them was interpolated ), as follows: for the first set of specimens without rehabilitation we apply to D2 ± 14 KN, to D3 ± 7.5 KN, to the second set of the specimens with “grinding weld toe” rehabilitation techniques we apply for D5 ± 14 KN, for D6± 7.5 KN and for third set of test specimens with “ WIG remelting weld toe” rehabilitation techniques, we apply to D8 ± 14 KN and to D9 ± 7.5KN.Forces applied to the specimens for sample D and the results obtained from fatigue tests are presented centralized in table 8.
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1.Works of strengthening and repair are concerned with the restoration of the stability, integrity and durability of the structure together with the bridges return to service. 2.Regular general maintenance of a bridge is also important in preserving the integrity and stability and preventing further damages from incurring. By following a logical and careful process of bridge conservation and using repairing and strengthening techniques that follow conservation guidelines such as those presented in this paper, successful intervention which respects the needs for performance improvements and cultural preservation may be performed. 3.commonly used retrofitting techniques for masonry arch bridges and finally the suggestions regarding the description of retrofitting and preserving bridge side by side adopting suitable techniques along with their respective pictures. 4.In case of extreme unrepairable cracks and other damages, we can conduct rebuilding technique with every step of carefulness and alertness so that it does not affect the identity of the historic structures.
Muscles are such a critical component of neuro-muscu- loskeletal dysfunction that some “manipulative” tech- niques focus almost exclusively on the detection and correction of muscle dysfunction. These include such techniques as receptor-tonus or Nimmo, trigger point, pro- prioceptive neuromuscular facilitation, muscle energy, post-isometric relaxation, and “spray and stretch”. Many of these techniques are available to the chiropractor as adjunctive procedures that may be used in combination with vertebral adjustment. These techniques are also driven by hypothetical models of muscle dysfunction, which lead to pain and/or become a functional component of the joint dysfunction.
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To clarify the characteristics of training that influence this plasticity, physiotherapy research has investigated the effects of both strengthening (Carroll, Riek, & Carson, 2002; Griffin & Cafarelli, 2007; Hauptmann, Skrotzki, & Hummelsheim, 1997; Rasch & Morehouse, 1957) and skill rehabilitation programmes (de Leon, Hodgson, Roy, & Edgerton, 1998a; de Leon, et al., 1998b; Nudo, et al., 1996; Recanzone, et al., 1993) on corticomotor function and have also contrasted outcomes of the two (Jensen, Marstrand, & Nielsen, 2005; Liu-Ambrose, et al., 2003; Remple, et al., 2001; Risberg, Holm, Myklebust, & Engebretsen, 2007). Because repetitive practice which does not progressively challenge motor execution is thought to be insufficient to prompt plasticity in the motor cortex (Plautz, Milliken, & Nudo, 2000), the increase in strength following isokinetic and isometric exercise is widely believed to result from morphological changes in muscle structure as a result of hypertrophy (enlargement of muscle fibres) (Esposito, et al., 2005; Folland & Williams, 2007; Kanehisa, et al., 2002; Rasch & Morehouse, 1957) and changes of muscle fibre types (Burkhead, et al., 2007). However, assessments in the early stages of strength training programmes show disproportionately larger increases in muscle strength compared to muscle size (Folland & Williams, 2007), suggesting some neural adaptations in the early phases of strength training (Burkhead, et al., 2007). Burkhead et al. (2007) suggest that these adaptations occur in the nervous system and facilitate more efficient motor unit recruitment. Rasch and Morehouse (1957), however, propose that these early strength gains are attributable to practised movement. They explain how repetition of the same movement may assist with postural adaptations, which increase maximal force applied to the target movement as well as refine and improve control over the motor pattern. This idea is supported by the finding that repetitive movements without a strength component have been shown to increase corticomotor excitability, but only for the first 10-25 s following conclusion of exercise (Hauptmann, et al., 1997), reinforcing the idea of a learning component or movement adaptations involved in the early phase of exercise.
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Picture a staircase you can get a clearer idea of how this process works by picturing a staircase where each step reflects an important marker for rehabilitation and the top of the stairs is the dream goal. In order to engage patients in this process it can be helpful to ask them to record and chart their progress. Their self-confidence can be enhanced by knowing how far they have already moved towards the dream goal. Thus, monitoring and evaluation of goals are impor- tant, as is re-setting goals that are too easy or too difficult to achieve in a given timescale. The importance of the psychological appraisals that athletes undertake regarding
lar stabilizers. The patient was taught abdominal hollow- ing and bracing techniques on the ball as these activities otherwise elicited pain when performed on the floor. Bridge track progressions on the gym ball and lunges were used to strengthen the gluteals as well as walking backwards on a treadmill to facilitate the gluteus maximus. Sensory-motor retraining was addressed using rocker board and balance sandals to facilitate the proprioceptive system in regula- tion of equilibrium and posture. The Brügger exercise 11
Mechanical low back pain (mLBP) is a clinical diagnosis made when spinal pain is produced by benign mechanical stimuli in the absence of an identifiable etiology. Despite the frequency of this diagnosis, identification of the tissues and mechanics associated with mLBP have remained elu- sive due to problematic investigative techniques. These include the inability to quantify tissue mechanics directly, restriction from use in large populations, unreliable tissue loading conditions and failure to quantify pain responses during the mechanical test itself. Given that most studies have utilized one of these problematic techniques, it is unlikely that the following research question has been answered accurately: is ‘mechanical’ back pain truly me- chanical in nature. Therefore, the primary goal of this study is to determine if the mechanical behaviours of specific spinal tissues are related to pain intensity and if this relation changes over the clinical history of mLBP. To achieve this goal, a non-invasive technique (ultrasonic indentation, UI) will be used to quantify the mechanical responses of lumbar vertebra and their overlaying soft tissues during controlled indentation loads. Specifically, UI will be modified for clinical use and performed pro- spectively in the treatment sessions of a mLBP out-patient population (n = 170). During UI, changes in pain intensity will be recorded continuously by a patient-held plunger and correlated to continual measures of vertebral displace- ment, soft tissue compression and spinal stiffness. It is expected that clinically significant correlations of pain and tissue mechanics will exist and these correlations will change with the resolution of the complaint. This study will be the first to examine a large population of mLBP patients using direct measures of tissue mechanics and will provide long over due data regarding the validity of mLBP as a diagnosis.
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♦ Sensory integration or Ayres method  empha- sises the role of sensory stimuli and perception in defining impairment after a brain lesion. Exercises are based on sensory feedback and repetition which are seen as important principles of motor learning. Neurorehabilitation principles and techniques have been developed to restore neuromotor function in gen- eral, aiming at the restoration of physiological move- ment patterns . Nevertheless, it must be recalled that the gold standard for functional recovery approaches is to tailor methods for specific pathologies and patients; however, none of the above-mentioned methods has been specifically developed for gait recovery after stroke . Thus, it is not surprising that the only available Cochrane review  on gait rehabilitation techniques states that there is insufficient evidence to determine if any rehabilitation approach is more effective in promot- ing recovery of lower limbs functions following stroke, than any other approach. Furthermore, Van Pepper  revealed no evidence in terms of functional outcomes to support the use of neurological treatment approaches, compared with usual care regimes. To the contrary, there was moderate evidence that patients receiving conventional functional treatment regimens (i.e. tradi- tional exercises and functional activities) needed less time to achieve their functional goals  or had a shorter length of stay compared with those provided with specific neurological treatment approaches, such as Bobath [47,51,71]. In addition, there is strong evidence that patients benefit from exercise programmes in which functional tasks are directly and intensively trained [70,72]. Task-oriented training can assist the natural pattern of functional recovery, which supports the view that functional recovery is driven mainly by adaptive strategies that compensate for impaired body functions [73-75]. Wevers at al., underlined in a recent review, the efficacy of task-oriented circuit class training (CCT) to improve gait and gait-related activities in patients with chronic stroke .
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Applying attention rehabilitation techniques may be associated with improved functioning on focused atten- tion, sustained attention, selective attention, alternating attention, and divided attention on a day-to-day basis as well as greater improvement on neuropsychological test performance, and engagement of chronic metham- phetamine patients in methamphetamine use treatment. Although there are as yet little data with regard to the effectiveness of these approaches in chronic meth- amphetamine users with attention deficits, there is a growing literature suggesting they may be effective in people diagnosed with brain injury and other disorders. For example, in their study on brain-damaged patients, Sturm and colleagues (1993) showed the effectiveness of attention training in increasing attention, reporting improved performance on neuropsychological tests spe- cific to the type of attention that was essentially trained. Further, in a series of studies on non focal brain injury, and post-concussive syndrome, Mateer and colleagues (1988, 1992) reported improvement following attention training not only on measures of attention, memory, and learning, but on levels of independent living and return to work. Sivak and colleagues (1984) reported improved driving performance following perceptual skills and attention training in a group of individuals with brain damage.
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Methods/Design: A mixed-method design was used to evaluate the alignment of rehabilitation services with the NRP in the Western Cape. Four rehabilitation study settings were selected to ensure that both inpatient and outpatient rehabilitation levels of care were covered at different contexts (rural and peri-urban). The sites were checked for the most prevalent rehabilitation-related conditions to ensure the identification of suitable instruments for measuring rehabilitation outcomes. Each study setting was linked to two researchers with one exploring the rehabilitation organizational structure of the sites and the other exploring the client outcomes after receiving rehabilitation services. Patients were evaluated at baseline and discharge, within seven days after admission and seven days prior to discharge. The evaluation was based on the rehabilitation organizational capacity to provide patient-oriented rehabilitation and the measurement of rehabilitation outcomes. Kaplan ’ s framework of organisational capacity was used in the context of each study setting. For the measurement of service users ’ outcomes, the International Classification of Functioning, Disability and Health was used (ICF). Standardised outcome measures were adopted for the domains of impairment, activity and participation. The World Health Organisation Community-Based Rehabilitation guidelines were used as guiding principles and concepts as suggested in the NRP.
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“Research design provides the glue that holds the research project together. It is used to structure the research, to show how all of the major parts of the research project work together to try to address the central research questions" (Trochim, 2005). This study applied descriptive research design since it allowed the researchers to observe the subjects in their natural environmental setting without affecting their behavior. Purposive sampling was used to sample the two rehabilitation schools: Kabete and Kirigiti Rehabilitation Schools which are boys’ medium risk and girls medium/ high risk institutions respectively located in Nairobi and Kiambu Counties respectively. Purposive sampling was used to sample 99 juvenile delinquents who had stayed at the institution for at least one year: 47 boys from Kabete and 52 girls from Kirigiti while systematic sampling was used to sample 21 parents of the ex-rehabilitees. Qualitative and quantitative data was collected through administration of structured questionnaires which had both open ended and closed ended questions. Key informant interviews were conducted to supplement the qualitative data.
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Statistical analysis was performed using SPSS 22.0. 1) Content validity ratio (CVR) index was used to evaluate the content validity using Lawshe method. 2) The intraclass correlation coefficient (ICC) index was used to investigate the test-retest reliability. 3) Cronbach’s alpha was used to check internal consistency. 4) The Shapiro-Wilk statistic was used to test the nor- mality of the distribution of all variables. 5) Paired t-test was used to compare the results before and after treatment in the rehabilitation group.
Initial evidence from a pilot trial of this system (Borstad A, Crawfis R, Phillips K, Pax Lowes L, Worthen-Chaudhari L, Maung D, et al.: In-home delivery of constraint induced movement therapy via virtual reality gaming is safe and feasible: a pilot study, submitted) suggests that improve- ments in motor speed, as measured by Wolf Motor Func- tion Test (WMFT) performance time , an outcome of prime importance to stroke survivors, are approximately equivalent to those reported in the traditional CI therapy literature [5, 13, 19, 25]. Qualitative data reveal that the technology is accepted irrespective of age, technological ex- pertise, ethnicity, or cultural background. Thus, this tech- nology has the potential to address the main barriers to adoption of CI therapy, while reducing the cost of care. A randomized clinical trial is now required to provide Level 1 evidence of the comparative effectiveness of this novel model of CI therapy delivery. Data from this trial will en- able individuals with motor disability to evaluate whether a home-based video game therapy has the potential to help them meet their rehabilitation goals compared to in-clinic CI therapy and traditional approaches. By combining novel gaming elements with the transfer package from CI ther- apy, this trial will also address a major limitation of re- habilitation gaming interventions that have been tried to
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The following systemic review investigates to what extent comorbidities can affect pulmonary rehabilitation outcomes (Hornikx et al., 2013). Hornikx et al. found four articles meeting the inclusion criteria during the systematic literature search. The independent variables were comorbidities, while the dependent variables were dyspnea, functional exercise capacity and quality of life. These became the outcomes that measured standard outpatient rehabilitation programs. The researchers of this study established a specific set of comorbidities which are: cardiovascular disease (ischemic heart disease, heart failure and hypertension), metabolic disease (diabetes, dyslipidemia and obesity), osteoporosis and/or anxiety and/or depression. The results of this study showed that dyspnea is less likely to improve if patients had anxiety or depression. Functional exercise capacity is also less likely to improve in patients with osteoporosis. The quality of life had less positive changes in patients with cardiovascular comorbidity. This research concluded that comorbidities had a negative effect on the outcomes of standard
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Vocational expert witnesses are often required to testify at trials on cases in which they have provided rehabilitation counseling services to disabled clients. Involvement in litigation may require a rehabilitation counselor to testify in a trial as a vocational expert witness. The litigation process differentiates rehabilitation practice in the heavily litigated private sector from the traditional non-litigated public rehabilitation programs and services arena (Cottone, 1982). The nature of the litigation process inherently involves the rehabilitation counselor, the plaintiff, the defendant, attorneys for the plaintiff, and the insurance carrier representative. The presence of third parties can complicate the traditionally confidential dyadic counseling relationship. Everything the plaintiff or defendant who is involved in litigation discloses to a rehabilitation counselor will be, in most instances, relayed back to others, such as the attorneys for the plaintiff or defense, or insurance carrier representatives.
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the “two implants” setting remains the reference in terms of mandibular complete rehabilitation, the protocol developed with four GSIs could be an interesting alternative for the care of very old and completely edentulous patients. However, the reliability of this procedure needs to be validated in a follow-up study. In parallel, assessment of the impact of such rehabilitation on masticatory and dietary behaviors and of its nutritional consequences would be of great interest
The CT myelogram was performed approximately ten months post-trauma with follow-up consultation approxi- mately one month later. The myelogram demonstrated some disc bulging at L4–5 and L5–S1 with left sided herniations but without definite evidence of nerve root impingement. The orthopaedic specialist diagnosed L3–4, L4–5 and L5–S1 degenerative disc disease and concluded that surgery was not indicated because the condition is back pain dominant. Therefore, he suggested that he con- tinue with his rehabilitation program for another six months, reduce his pain medication intake and attempt modified duties.
Any rehabilitation programme or intervention delivered within the home environment aimed at tackling secondary prevention of vascular risk factors and events following an initial cardiovascular event will be eligible for inclusion, e.g. educational programmes, aerobic or exercise classes, self-management and life- style interventions. Trials will be included with com- parative control groups and trials with multiple intervention arms, allowing comparison of different types of rehabilitation programmes. This study will not include population or community-wide interven- tions (e.g. mass media campaigns).
There are several directions that can be pursued for the future work of the real time myoelectric control scheme. Using the developed pattern recognition myoelectric control scheme, one could develop robotic devices for rehabilitation exercises. These rehabilitation robotic devices would use the myoelectric control scheme to assist subjects in movement in order to help strengthen their muscles. It could also be used to extend the range of motion for someone like the CCS subject who did not have full mobility of several motions of the arm. Ultimately it would be beneficial to develop rehabilitation robotic devices that could assist in everyday life for those needing assistance at all times. It would be desirable to extend the real time myoelectric control scheme to subjects with other conditions and disabilities besides CCS. CCS is only one condition of the many neuromuscular disabilities that might benefit from applications involving myoelectric control schemes. Other changes could certainly be attempted in order to make the classification accuracy better. This would include testing of other features, classifiers, and windowing schemes. Another approach one could use to increase the accuracy is adding other electrode locations or trying to target different muscles. One could also try to extend the three DOF to four or five DOF by adding motions of the shoulder. In preliminary work, experiments were completed which attempted to run two classifiers in parallel. If this implementation would work, it would allow for movement in multiple DOF. There was no success at accomplishing this, but in the future the parallel classifier concept could be reattempted.
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The result shows that all the treatment protocols were ef- fective in improving balance and function of OA knee pa- tients. However, the comparison of post test values of FRT and TUG test between the control and the experimental group clearly shows that the experimental group had bet- ter improvement than the control group. Subjects can re- turn to a higher level of activity if perturbation and agili- ty are given as mentioned by G Kelley Fitzgerald, John D Childs et al. (2000) .According to Hall M.C and Brody LT (1999). The functional improvement seen in the con- trol group could be contributed to isometric exercises, strengthening the exercise of Quadriceps and Hamstring, Straight leg raise exercise and Stretching of calf and ham- string. These exercises are thought to stimulate the mecha- noreceptors present in the joint capsules and ligaments — the movement of joint relay proprioception to the higher center. Weight-bearing exercises stimulate Type I (Ruffini) and Type III (Golgi type) receptors to generate an impulse. Type I receptors are responsible for the detection of joint pressure applied, and Type IV (free nerve endings) detect rapid joint movement as well as deep pressure, perpendic- ular compression of a joint capsule like the one performed during the weight-bearing posture. In a closed kinetic chain exercise, the indirect forces are transferred and re- ceived from the muscles of adjacent segments . Sullivan OS (2001) has stated that, during isometric con- traction, the muscle produces force without causing any change in the muscle length, which leads to the production of measurable tension in the muscle. The isometric exer- cises thus help in improving muscle tone, static endurance while in turn prepares the joint for vigorous activities. Da- vis MA, Ettinger WH, (1995) has stated that OA subjects suffer from progressive loss of function, which leads to in- creased dependency while lower limb activities and ADL. Incorporating agility and balance training techniques to the regular rehabilitation protocol can enhance the effec- tiveness of treatment in subjects with instabilities of joint [18,19].The significant improvement in the functional per- formance of the experimental group over the control group could be due to the effect of perturbation training. With perturbation training, there is pivoting, faster changes in direction which tackle their balance function. These extra training developed motor skills for knee joints when there