Preoperative education and its influence on perception of recovery for clients awaiting total hip and total knee replacement surgery /

The puqjose of this study was to examine the manner in which an inviting approach to a preoperative teaching and learning educational experience influenced the perception and subsequent recovery of clients who were awaiting total hip and total knee replacement surgery. An in-depth review of the internal and external factors that shape client perceptions was undertaken in this study. In addition, this study also explored whether or not the Prehab Program was preparing clients physically, socially, and psychologically for surgery. Data for this qualitative case study research were collected through preoperative interviews with 4 participants awaiting total hip replacement surgery and 1 participant awaiting total knee replacement surgery. Four postoperative interviews were conducted with the participants who had received total hip replacement surgery. The occupational therapist and physical therapist who were the coleaders of the Prehab Program at the time of this study were also interviewed. The results of this study suggest that while individuals may receive similar educational experiences, their perceptions of the manner in which they benefited from these experiences varied. This is illustrated in the research findings, which concluded that while clients benefited physically from the inviting approach used during the practical teaching session, not all clients perceived the psychological benefits of this practice session, especially clients with preexisting high levels of anxiety. In addition to increasing the understanding of the internal as well as external factors that influence the perceptions of clients, this study has also served as an opportunity for reflection on practice for the Prehab therapists and other healthcare educators.

Glucose dynamics in rat skeletal muscle : recovery from osmotic stress

The purpose of this study was to examine cell glucose kinetics in rat skeletal muscle during iso-osmotic recovery from hyper- and hypo-osmotic stress. Rat EDL muscles were incubated for sixty minutes in either HYPO (190 mmol/kg), ISO (290 mmol/kg), or HYPER (400 mmol/kg) media (Sigma medium-199, 8 mM glucose) according to an established in vitro whole muscle model. In addition to sixty minute baseline measures in aniso-osmotic conditions, (HYPO-0 n=8; ISO- 0, n=S; HYPER-0, n=8), muscles were subjected to either one minute (HYPO-1 n=8; ISO-1, n=8; HYPER-1, n=8) or five minutes (HYPO-5 n=8; ISO-5, n=8; HYPER-5, n=8) of iso-osmotic recovery media and analyzed for metabolite content and glycogen synthase percent activation. To determine glucose uptake during iso-osmotic recovery, muscles (n=6 per group) were incubated for sixty minutes in either hypo-, iso-, or hyper-osmotic media immediately followed by five minutes of iso-osmotic media containing 3H-glucose and 14 C-mannitol. Increased relative water content/decreased [glucose] (observed in HYPO-0) and decreased water content/increased [glucose] (observed in HYPER-0) returned to ISO levels within 5 minutes of recovery. Glycogen synthase percent activation increased significantly in HYPO-5 over iso-osmotic controls. Glucose uptake measurements revealed no significant differences between groups. It was determined that [glucose] and muscle water content rapidly recovered from osmotic stress demonstrating skeletal muscle's resilience to osmotic stress.

Therapeutic riding : learning and recovery for people with disabilities

The purpose ofthis study was to explore the process oftherapeutic riding as an experiential and holistic approach to learning and recovery for people with disabilities as perceived by the providers oftherapeutic riding. To enhance the connection between theory and practice and to suggest future research, the researcher endeavoured to develop a theory that contributed to the knowledge base oftherapeutic riding, animal-assisted therapy and education, experiential education, and experiential therapy in addition to contributing to connections among them. This topic was investigated because ofthe lack ofresearch about the process of therapeutic riding, particularly from learning and a recovery perspective. Few studies have addressed how therapeutic riding outcomes are achieved or how the therapeutic riding process actually works. This study was identified as grounded theory using qualitative data through interviews and narrative reflections with therapeutic riding providers, a researcher's journal, field notes, and written documents. Grounded theory analysis was used to analyze the qualitative data. This consisted ofdoing open, axial, and selective coding. This study provided detailed descriptions ofthe research approach, researcher's involvement, participant and site selection, data collection and analysis, methodological assumptions and limitations, credibility established, and ethical considerations. The findings ofthe data analysis revealed the theme ofrelationships as central to the learning and recovery process oftherapeutic riding for people with disabilities. The significance ofthe team relationships, the horse and rider relationship, and the providers and rider relationship was found. The essential components ofthe learning and recovery process were presented in a diagram in the selective coding phase. Goals oftherapeutic riding included psycho-education; behavioural and social; physical; and equestrian. Parts ofthe process ofhow outcomes were achieved included motivation; "opens new doors;" risk; task analysis; control; communication; and environmental factors. Outcomes of therapeutic riding included independence and mobility; confidence; and transfer abilities or skills. The implications ofthese findings for theory, practice, and further research were also. explored.

The Role of Pyruvate Dehydrogenase Kinase-4 in Post-Exercise Glycogen Recovery

The pyruvate dehydrogenase (PDH) complex regulates the oxidation of carbohydrates in mammals. Decreased activation of PDH following exhaustive exercise may aid the resynthesis of glycogen through increased activity of PDH kinase-4 (PDK4), one of four kinases that decrease the activity of the PDH complex. The purpose of this study was to examine the role of PDK4 in post-exercise glycogen resynthesis. Wild-type (WT) and PDK4-knockout (PDK4-KO mice) were exercised to exhaustion and were sampled at rest (Rest), at exercise exhaustion (Exh), and after two-hours post-exercise (Rec). Differences in feeding post-exercise led to the addition of a PDK4-KO group, pair-fed (PF) with WT mice. Glycogen fully recovered in all Rec groups in muscle however remained low in the PF group in liver. Flux through PDH was elevated in PDK4-KO muscle with feeding and low in the PF group in both tissues. This suggests PDK4 may fine-tune flux through PDH during exercise recovery.

Neuromotor Mechanisms Involved in the Recovery from Local Muscular Fatigue

The phenomenon of over-recovery consists of a participant’s maximal force levels returning to values above initial levels. The present study examined the presence and causes of over-recovery following local muscular fatigue. Fourteen males completed two fatigue protocols consisting of maximal isometric dorsiflexion contractions. Upon completion of the fatigue protocol participants’ force was monitored over a 15 minute recovery period. Dorsiflexion force and surface electromyography (sEMG) from the tibialis anterior and soleus were monitored concurrently. Following the two fatigue conditions (10 and 20% force decrement) force recovered to 100.5 and 99.5% of initial levels for each condition, respectively. Surface EMG root-mean-square amplitude and MPF exhibited changes consistent with a warm-up effect. It was concluded that over-recovery was not present in the tibialis anterior following a local muscular fatigue. However, the return in force to initial values, rather than a persistent decrement as normally observed, was mediated by the warm-up effect.

Anachronistic Me: An Autoethnographic Account of Recovery through Volunteerism

The purpose of this autoethnography was to reflect upon the ways in which my recovery was aided by the personal connections made while volunteering in a homeless shelter. Congruent with autoethnographic best practice, data were collected through a variety of means, including: journaling, field notes, participant observation, and collection of artifacts. An autoethnographic narrative emerged out of the analysis of data detailing my recuperative journey. Results indicated that my time spent volunteering at the shelter: (a) fostered a sense of Community, (b) made me aware of Realizations that broadened my perspective, and (c) aided in motivating me to be Intentional about Improving my Life. These three themes proved to be important factors in my recovery process. This thesis will inform social science researchers and health advocates by making a contribution to the growing body of literature regarding recovery.