Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

A Novel Distractive And Mobility-Enabling Lumbar Spinal Orthosis For Treating Mechanical Low Back Pain, Daniel Clay Hillyard

Theses and Dissertations (ETD)

Introduction: Lumbar spinal orthoses (LSOs) are often used as non-surgical treatment and serve to support the spine and alleviate low back pain. More recently, dynamic orthoses claiming to decompress the spine have been introduced. Currently, there is an unserved population of people that suffer from mechanical low back pain (LBP) conditions, such as degenerative disc disease or lumbar foraminal stenosis, that would benefit from spinal decompression and mobility. A previously-developed prototype of dynamic mobility orthosis (DMO1) was designed that provided a distractive load across the lumbar spine but required higher sagittal bending moments and was unable to maintain spinal off-loading …

Quantifying Joint Coordination Variability In Anterior Cruciate Ligament-Reconstructed Individuals During Walking, Kylie Davis

Theses and Dissertations (ETD)

The knee is the second most common joint to sustain injury. An estimated 200,000 anterior cruciate ligament (ACL) ruptures occur each year in the United States alone, and about 100,000 ACL reconstruction (ACLR) surgeries are performed annually. There is a significant risk of developing osteoarthritis of the knee after incurring an ACL injury, and the incidence of ipsilateral or contralateral injury is six times greater in individuals who have a surgically repaired ACL. Past studies have analyzed kinetic and kinematic characteristics of individual lower extremity joints to reveal differences between subjects with and without ACLR. Despite reports of altered kinematic …

Design, Validation, And Clinical Testing Of A Novel Fastening Device For A Scoliosis Brace, Cody Keith Bateman

Theses and Dissertations (ETD)

Each year, thirty thousand children in the US were put into a scoliosis brace. The primary function of scoliosis braces was to reduce and prevent progression of the spinal deformity as the patient grew by application of corrective forces to the spine. Straps, often made of Velcro, were attached to the back of the brace that applied forces to the spine when the straps were tightened. Braces were prescribed to be worn up to 23 hours a day. Studies have concluded that discomfort increased with increasing strap tension and pad pressure. They have also shown an increase in strap tension …

Genome-Scale Precision Proteomics Identifies Cancer Signaling Networks And Therapeutic Vulnerabilities, Hong Wang

Theses and Dissertations (ETD)

Mass spectrometry (MS) based-proteomics technology has been emerging as an indispensable tool for biomedical research. But the highly diverse physical and chemical properties of the protein building blocks and the dramatic human proteome complexity largely limited proteomic profiling depth. Moreover, there was a lack of high-throughput quantitative strategies that were both precise and parallel to in-depth proteomic techniques. To solve these grand challenges, a high resolution liquid chromatography (LC) system that coupled with an advanced mass spectrometer was developed to allow genome-scale human proteome identification. Using the combination of pre-MS peptide fractionation, MS2-based interference detection and post-MS computational interference correction, …

The Effect Of Hamstring Lengthening On Pelvic Tilt And Lumbar Lordosis, Michael Scott Braman

Theses and Dissertations (ETD)

A direct correlation between hamstring tightness and severity of lower back pain (LBP) has been previously reported. Hamstring contraction creates knee flexion, hip extension and posterior pelvic tilt. Posterior pelvic tilt causes the lumbar spine to flatten (hypolordosis) which places pressure on the anterior structures of the spine, including the intervertebral disc. This increased pressure may predispose individuals to disc degeneration and associated pain. For this reason, hamstring stretching is often prescribed to alleviate LBP, however, the effect of hamstring lengthening on the kinematics of the lumbar spine and pelvis is not well understood. Accurate measurement of lumbar spine movement …

A Subject Specific Surface Electromyography Model For Estimating L4/L5 Compressive Loading, Pablo Joaquin Dopico

Theses and Dissertations (ETD)

Introduction: Low Back Pain (LBP) is a leading cause of activity limitation worldwide and results in 149 million lost work days annually in the United States. The total costs of LBP are estimated to be $100 to $200 billion annually. Specific causes of LBP account for less than 15% of LBP cases. Heavy loading of the lumbar spine and tight hamstrings have been identified as risk factors for LBP. Tight hamstrings pull the pelvis posteriorly and reduce the lordosis of the spine, resulting in increased loading of the lumbar vertebral bodies of the spine. While this mechanism has been described, …

Scoliosis Analog Model For The Evaluation Of Bracing Technology, Chloe Ly Chung

Theses and Dissertations (ETD)

Thoracolumbar braces are commonly used to treat Adolescent Idiopathic Scoliosis (AIS). Braces serve to reduce and prevent progression of the spinal curve by applying corrective forces. The magnitude and direction of these corrective forces applied by the brace to the spine remain unknown. Additionally the brace fitting process involves making alterations to the brace that affect its corrective force capacity. The objective was to design and validate an analog model of a mid-thoracic single curve scoliotic deformity for quantifying structural properties of the brace and the force response of the brace on the spine. This model was used to investigate …

Kinematic And Kinetic Effects Of Alterations In Lumbar Lordosis In People With Tight Hamstrings, Dema Assaf

Theses and Dissertations (ETD)

The etiology of nonspecific low back pain is sparsely understood. To better understand the contributing factors to nonspecific low back pain, there are often common concurrent pathologies that are investigated to determine their functional relationship to low back pain. One such pathology, investigated further in this thesis, is tight hamstrings. Specifically, the effect of hamstring length on pelvic position during gait and activities of daily living under normal and altered spinal position were investigated as part of this study in a motion analysis lab.

First, a marker validation study was conducted to ensure the accuracy of sagittal spinal measures of …

Adverse Effects Of Asparaginase In Pediatric Patients With Acute Lymphoblastic Leukemia, Chengcheng Liu

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer. Asparaginase is a critical treatment component for ALL. However, its use is complicated by adverse effects, such as hypersensitivity, osteonecrosis and pancreatitis.

Hypersensitivity to asparaginase typically requires discontinuation of current formulation and substitution with other formulations, but the differential diagnosis can be challenging, and the diagnostic utility of antibody tests is unclear. We comprehensively analyzed anti-Elspar (native E.coli asparaginase) IgG antibodies in 410 pediatric patients treated on an asparaginaseintensive front-line clinical trial. Of 169 patients (41.2%) who exhibited clinical allergy, 147 (87.0%) were positive for anti-Elspar antibody. Of …

Development Of A Mobility-Enabling Spinal Orthosis And Methods For Evaluating And Developing Spinal Orthoses On A Robotic Platform, John C. Simmons

Theses and Dissertations (ETD)

Introduction: A number of decompressing spinal braces (typically pneumatic) have been introduced that attempt to mechanically emulate the “buoyancy” of water therapy by offloading upper torso load to the pelvic girdle as a treatment for lower back pain (LBP). Unfortunately, the beneficial upward force they apply on the upper torso typically makes it difficult or impossible for the patient to bend. For those cases where stabilization is not indicated, this undesirably hinders therapeutic exercise, independent living, and return to work. The cosmetic stigma of wearing an external pneumatic assembly large enough to provide significant offloading may provide additional disincentives to …

Mapping The Spatial And Temporal Dynamics Of Sensorimotor Integration During The Perception And Performance Of Wallowing, Megan E. Cuellar

Theses and Dissertations (ETD)

Similar to other complex sequences of muscle activity, swallowing relies heavily upon ‘sensorimotor integration.’ It is well known that the premotor cortex and primary sensorimotor cortices provide critical sensorimotor contributions that help control the strength and timing of swallowing muscle effectors. However, the temporal dynamics of sensorimotor integration remains unclear, even when performed normally without neurological compromise. Recent advances in EEG analysis blind source separation techniques via independent component analysis offer a novel and exciting opportunity to measure cortical sensorimotor activity in realtime during swallowing, concurrently with muscle activity during swallow initiation. In the current study, mu components were identified, …

Strengths And Weaknesses Of Hybrid Tpr Technology For Obtaining Structural And Mechanistic Insights Into Tpr Proteins, Shanshan Yu

Theses and Dissertations (ETD)

Tetratricopeptide (TPR) repeats are a 34-residue helix-turn-helix motif that when repeated pack into a superhelical structure. TPR domains are frequently found mediating protein-protein interactions, often through a central groove. One protein complex bearing numerous TPR repeats is the Anaphase Promoting Complex (APC). The anaphase-promoting complex (APC) is a multi-subunit complex, which orchestrates mitotic cell cycles. APC is an E3 ligase in the ubiquitin cascade, and directs the 26S proteosome degradation of cell-cycle regulators. Throughout mitotic progression, proteins that are key regulators of the cell cycle are assembled with polyubiquitin chains by APC.

One domain of the human APC is comprised …

Determination Of The Functional Relationship Between Lumbar Lordosis And Pelvic Tilt, Casey Tyler Hebert

Theses and Dissertations (ETD)

Americans are undergoing spinal fusion surgery (SFS) at an ever increasing rate; in 2008 over 400,000 Americans underwent SFS with a national cost of approximately $33.9 billion. During SFS it is difficult for the surgeon to properly align the spine’s s-shape, as viewed from the patient’s side. Abnormal alignment of the spine then alters the position of the pelvis and hip joints, which may impact the function and hip contact patterns. Several studies have shown that patients with spinal pathology, such as arthritis, often have a coexisting hip pathology or subsequently develop hip pathology, and it is estimated that 18% …

Total Knee Arthroplasty Wear Is Caused By Malrotation And Excessive Laxity, Erik Woodard

Theses and Dissertations (ETD)

Total knee arthroplasty is a proven technique which combines specially designed components and surgical processes to treat cartilage degeneration and alleviate pain in arthritic knees. However, this technique is limited by component design and surgical precision. Due to these limitations, knee arthroplasty components will eventually wear out, causing rejection and necessitating the need for a replacement. For this reason, it would be beneficial to experts if the primary causes of this wear could be identified in order to minimize the number of replacements.

This study aims to determine if a correlation exists between instability of a knee joint and the …

Development And Application Of A Biorobotic Simulation Of Stance Phase Gait To Study Foot And Ankle Kinematics, Kelly N. Salb

Theses and Dissertations (ETD)

Ankle instantaneous axis of rotation (IAR) measurements represent a more complete parameter for characterizing joint motion. However, few studies have implemented this measurement to study normal, injured, or pathological foot-ankle biomechanics. Additionally, while load is suggested to play a major role in ankle biomechanics, including influences on articular surfaces, bony motion, and formation of the arches, studies concerning the effects of joint loading are limited.

A novel testing protocol was developed to simulate in vivo mechanics of the foot-ankle complex during early stance phase gait in a human cadaveric model. Two studies were conducted. The first study was to assess …

In Vitro Manual Therapy And Biorobotic Simulation Of Glenohumeral Joint Mobilization Techniques, Hunter Johnson Smith

Theses and Dissertations (ETD)

Physical therapists (PT) employ mobilization techniques for restoring range of motion to joints. Few studies have attempted to quantify the biomechanics of manual therapy on the glenohumeral (GH) joint. The objectives of this study were to develop an in vitro protocol to determine the biomechanical effects of joint mobilization on the GH joint, and to then simulate these mobilizations in the University of Tennessee Health Science Center (UTHSC) Joint Implant Biomechanics Laboratory’s Robotic Testing Platform (RTP).

The GH joint is an incredibly shallow socket joint. This gives the joint an unusually large range of motion (ROM) compared to other ball …

Bone Properties Of Recombinant Inbred Line - Bxd Mouse, Yueying Angela Zhang

Theses and Dissertations (ETD)

Osteoporosis is identified by reduced bone mass, decreased bone quality and altered bone micro-architecture. These traits are quantitative and also highly regulated by genetic and environmental factors. As a powerful tool for collaborative analysis of quantitative traits and gene function, BXD recombinant inbred (RI) lines mice have been used to identify genetic effects for bone density.

For the first time, we investigated the bone properties of BXD RI mice by analyzing femur and tibia and compared their phenotypes of different compartments. In this study, microcomputed tomography (µCT) provided an accurate measurement on characterizing bone quality and bone architecture ex-vivo; three-point …

The Development And Application Of A Custom Robotic Biomechanical Testing Platform Employing Real-Time Load-Control To Compare Spinal Biomechanical Testing Protocols: Pure Moment, Ideal Follower Load, And A Novel Trunk Weight Protocol, Charles Ramsey Bennett

Theses and Dissertations (ETD)

The human lumbar spine has been the subject of biomechanical study for many decades owing to the numerous medical cases resulting in the development of various corrective surgical procedures and medical devices intended to relieve patient discomfort. Spinal biomechanics is a broad field containing but not limited to the in vitro study of cadaveric tissue utilizing testing platforms used to apply motion- or load-profiles to tissue in the investigation of the various kinetic or kinematic responses, respectively. The particular arena field of this research concerns the field of robotics as it applies to testing platforms and how they are applied …

An Innovative Testing Protocol To Study Foot And Ankle Kinetics During Early Stance Phase Of Gait, Thomas E. Stewart

Theses and Dissertations (ETD)

The objective of this study was to improve upon existing testing platform limitations with respect to foot and ankle mechanics in the sagittal plane during dorsiflexion and plantar flexion. The intent was to develop a multi-loading protocol that simulated aspects of early stance phase of walking gait. This data were used to evaluate the influence an Achilles load has on the kinematic profile of the ankle complex. Also, resulting kinematic profile data can be used to evaluate ligament/tendon effects, ankle arthroplasty, and various surgical techniques.

A pair of cadaveric human feet, from the same donor, 50 years of age were …

The Effect Of Progesterone Only Contraception On The Accuracy Of Cervical Cytologic Interpretation, Michelle Reneé Collins

Theses and Dissertations (ETD)

Abstract Introduction: Papanicolaou screening is the standard of care for the detection of abnormal cervical cells. Early detection and treatment of cervical neoplasia depends on the accurate interpretation of the cytologic sample. Diagnosis of dysplasia is made by histology interpretation to confirm the results of cytology screening. Cervical cells are susceptible to change as a result of hormonal exposure, and this has the potential to affect cytologic interpretation. Cervical cells may be exposed to exogenous progesterone if the woman uses injectable depot medroxyprogesterone acetate or a progesterone intrauterine device. Previous study results have been inconsistent regarding the effect of progesterone …

Use Of A Spine Robot Employing A Real Time Force Control Algorithm To Develop, Simulate, And Compare Spinal Biomechanical Testing Protocols: Eccentric Loading, Pure Moment, And A Novel Head Weight Protocol, Daniel Mark Wido

Theses and Dissertations (ETD)

In vitro testing provides a critical tool for understanding the biomechanics of the subaxial cervical spine. Previous common testing protocols used to evaluate the subaxial cervical spine include Pure Moment (PM), follower load, and eccentric lever arm (EL) loading methods. Although these methods are widely accepted, there is always a goal to try to better simulate physiologic loading conditions. While the follower load attempts to simulate compression due to muscle activation, no previous protocol has taken into account the constant vertical force vector applied to C2 produced by the weight of the human head. Furthermore, we are unaware of previous …

Effect Of Occlusion, Directionality And Age On Horizontal Localization, Lynzee Nicole Alworth

Theses and Dissertations (ETD)

Localization acuity of a given listener is dependent upon the ability discriminate between interaural time and level disparities. Interaural time differences are encoded by low frequency information whereas interaural level differences are encoded by high frequency information. Much research has examined effects of hearing aid microphone technologies and occlusion separately and prior studies have not evaluated age as a factor in localization acuity. Open-fit hearing instruments provide new earmold technologies and varying microphone capabilities; however, these instruments have yet to be evaluated with regard to horizontal localization acuity.

Thus, the purpose of this study is to examine the effects of …

Application Of A High‑Resolution Computed Radiography System In Detecting An Iodinated X‑Ray Contrast Agent: Small Animal Phantom Study, Anobel Maghsoodpour

Theses and Dissertations (ETD)

Tumor angiogenesis, the creation of new blood vessels, is the characteristic of solid tumors and crucial for their development. Iodinated contrast agents are used to increase the X‑ray detectability of zone of angiogenesis, and thus providing a means for tracking tumor growth.

The overall objective of this project was to evaluate the performance of Kodak CR 7400, a high‑resolution compact computed radiography (CR) system in detection of Omnipaque‑240, an iodinated contrast agent, in a phantom mimicking small animal tumor model.

The first phase of the project was dedicated to a comprehensive assessment of CR image quality by measuring presampled Modulation …

Biomechanical Comparison Of Traditional Laminectomy And Minimally‑Invasive Facetectomies, Karen Sedacki

Theses and Dissertations (ETD)

The facet joints of the lumbar spine are one of the sources of low‑back pain that affects a great portion of the population. Minimally‑invasive (MI) procedures have been becoming more popular in the surgical decompression of the spine because they offer shorter recovery time and involve removal of smaller amounts of important structures. With these features, it is believed that MI procedures lead to less clinical instability, and the functionality of the segment is maintained. Another important factor is how the facet angle in the lumbar segments affects the biomechanical instability. In spite of all this interest in MI procedures, …

Use Of A Multi-Axis Robotic Testing Platform To Investigate The Sagittal Mechanics Of The Multi-Body Lumbar Spine, Jessica Rose Stubbs

Theses and Dissertations (ETD)

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 …

The Development And Psychometric Testing Of A Hypertension Knowledge Instrument In A Vulnerable Population, Crescent Elayne Rowell

Theses and Dissertations (ETD)

The primary objective of the study was to assess the psychometric properties of a hypertension knowledge instrument in a vulnerable population. The secondary objective was to determine the association between hypertension knowledge and outcomes such as systolic and diastolic blood pressure and hemoglobin A1c.

A cross-sectional study was conducted using a convenience sample of 196 adults aged 18 years and older with hypertension. Item analysis was conducted to determine the reliability of the instrument. The factor structure was determined and confirmed using exploratory factor analysis and confirmatory factor analysis, respectively. Logistic regression analysis was used to determine the association between …

Effect Of Fixation Using Locked Compression Plate Versus Lag Screws On Biomechanics Of Talonavicular Joint: A Human Cadaveric Foot Model, Rahul Sudheer Ghotge

Theses and Dissertations (ETD)

Introduction: Talonavicular fusion is a surgery used for treating many hind foot pathologies. A problem associated with the procedure is non-union which may be due to inadequate stabilization. The objective of our study was to compare the effect of two surgical fixation techniques on the motion and biomechanics of the talonavicular joint in a human cadaveric foot model.

Materials and Methods: Thirteen human cadaveric foot specimens were prepared, mounted in a multi-axis programmable robot, and loaded using four loading scenarios. Each of the four loading scenarios consisted of a constant Achilles tendon load of 350N followed by either internal or …

A Passive Pure Moment Protocol For Testing Spine Segments: Development And Application, Kyle David Fraysur

Theses and Dissertations (ETD)

The pure moment protocol is the accepted standard for performing in-vitro biomechanical testing of spinal devices. Published studies predominantly report range of motion and flexibility data, but information regarding the segment center of rotation is also relevant. Most current pure moment platforms are not sensitive enough to accurately calculate the instantaneous axis of rotation (IAR) for a segment throughout a bending motion. The purpose of this study was to simulate a pure moment protocol using a programmable spine robot, and use the data gathered to calculate the IAR for harvested specimen and those implanted with a constrained total disc replacement …

The Use Of Preclinical Models To Improve The Treatment Of Retinoblastoma, Katie Marie Nemeth

Theses and Dissertations (ETD)

Rodent models play an essential role in the development of new chemotherapeutics and dosing regimes. It is often difficult to carryout a clinical study for pediatric cancers due to the small patient population. Retinoblastoma, a pediatric cancer of the eye, is one example of a pediatric cancer that can benefit from preclinical studies. Over the years various retinoblastoma rodent models have been developed used to test various combination of broad-spectrum systemic chemotherapy. It was found form these studies that the combination of topotecan and carboplatin was effective. However both drugs cause myelosuppression and therefore administrating both of these drugs systemically …

Development And Application Of Computational Tools For The Study And Optimization Of Variable Resolution X-Ray (Vrx) Computed Tomography Scanners, David Alejandro Rendon

Theses and Dissertations (ETD)

The overall goal of this project was to develop and apply important computerized aids for the design and implementation of Variable Resolution X-ray (VRX) CT scanners developed at the University of Tennessee, Memphis. VRX scanners take advantage of the “projective compression” principle that allows the same device to image objects of very different sizes with the same level of detail by adjusting the field of view and the reconstruction resolution.

The first part of this project aimed to develop a set of computational tools specifically tailored for the design, implementation and study of VRX scanners. This included creating a reconstruction …