Demographic and metabolic characteristics of individuals with progressive glucose tolerance

We evaluated changes in glucose tolerance of 17 progressors and 62 non-progressors for 9 years to improve our understanding of the pathogenesis of type 2 diabetes mellitus. Changes in anthropometric measurements and responses to an oral glucose tolerance test (OGTT) were analyzed. We identified 14 pairs of individuals, one from each group, who were initially normal glucose tolerant and were matched for gender, age, weight, and girth. We compared initial plasma glucose and insulin curves (from OGTT), insulin secretion (first and second phases) and insulin sensitivity indices (from hyperglycemic clamp assay) for both groups. In the normal glucose tolerant phase, progressors presented: 1) a higher OGTT blood glucose response with hyperglycemia in the second hour and a similar insulin response vs non-progressors; 2) a reduced first-phase insulin secretion (2.0 ± 0.3 vs 2.3 ± 0.3 pmol/L; P < 0.02) with a similar insulin sensitivity index and a lower disposition index (3.9 ± 0.2 vs 4.1 ± 0.2 µmol·kg-1·min-1 ; P < 0.05) vs non-progressors. After 9 years, both groups presented similar increases in weight and fasting blood glucose levels and progressors had an increased glycemic response at 120 min (P < 0.05) and reduced early insulin response to OGTT (progressors, 1st: 2.10 ± 0.34 vs 2nd: 1.87 ± 0.25 pmol/mmol; non-progressors, 1st: 2.15 ± 0.28 vs 2nd: 2.03 ± 0.39 pmol/mmol; P < 0.05). Theses data suggest that β-cell dysfunction might be a risk factor for type 2 diabetes mellitus.

Effect of frequency of static stretching on flexibility, hamstring tightness and electromyographic activity

We compared the effect of the number of weekly repetitions of a static stretching program on the flexibility, hamstring tightness and electromyographic activity of the hamstring and of the triceps surae muscles. Thirty-one healthy subjects with hamstring tightness, defined as the inability to perform total knee extension, and shortened triceps surae, defined by a tibiotarsal angle wider than 90° during trunk flexion, were divided into three groups: G1 performed the stretching exercises once a week; G2, three times a week, and G3, five times a week. The parameters were determined before and after the stretching program. Flexibility improved in all groups after intervention, from 7.65 ± 10.38 to 3.67 ± 12.08 in G1, from 10.73 ± 12.07 to 0.77 ± 10.45 in G2, and from 14.20 ± 10.75 to 6.85 ± 12.19 cm in G3 (P < 0.05 for all comparisons). The increase in flexibility was higher in G2 than in G1 (P = 0.018), while G2 and G3 showed no significant difference (G1: 4 ± 2.17, G2: 10 ± 5.27; G3: 7.5 ± 4.77 cm). Hamstring tightness improved in all groups, from 37.90 ± 6.44 to 29 ± 11.65 in G1, from 39.82 ± 9.63 to 21.91 ± 8.40 in G2, and from 37.20 ± 6.63 to 26.10 ± 5.72° in G3 (P < 0.05 for all comparisons). During stretching, a statistically significant difference was observed in electromyographic activity of biceps femoris muscle between G1 and G3 (P = 0.048) and G2 and G3 (P = 0.0009). No significant differences were found in electromyographic activity during maximal isometric contraction. Stretching exercises performed three times a week were sufficient to improve flexibility and range of motion compared to subjects exercising once a week, with results similar to those of subjects who exercised five times a week.

Attention focus and balance control in young and older adults

This thesis investigated attention focus and balance control in eighteen healthy young adults and eighteen healthy older adults. All participants performed sixteen consecutive trials of a balance task which involved standing for 30-s on an unstable platform that could rotate only in the roll direction. There were no attention focus instructions provided on any of the sixteen trials. Following the completion of the initial and final attempt in the series, participants reported "where" their attention had been focused when performing the task. The results showed differences in balance between young and older adults and improvements in balance with practice in both young and older adults. However, there were no differences in attention focus strategies between young and older adults. Both age groups directed attention to multiple sources during the balance task. An equal focus on internal (i.e., feet, trunk, and other body parts) and external (i.e., the platform) sources with little focus on events not related to the task dominated on the first attempt of the balance task. Focus on internal sources was maintained and focus on events not related to the task increased at the expense of focus on external sources on the final attempt of the balance task. Following the series of sixteen trials to establish "natural" attention focus, participants performed three randomly presented trials, each with specific attention focus instructions (i.e., think about minimizing movements of the feet, the trunk, or the platform). The results showed that, in contrast to the literature, instructions to focus on an internal source, the trunk, actually augmented control of the task as reflected in reduced trunk sway whereas instructions to focus on an internal source, the feet, or an external source, the platform, did not benefit performance on the task. Thus, the distance fi-om the interaction point of the body with the external source is critical and may not depend on whether the source is internal or external. Thus, a global attention focus instruction may not be beneficial and the nature of the task should be considered when adopting attention focus instructions for young and older adults.

The influence of physical activity behaviour on the relationship between motor proficiency and body composition in children

There is an emerging awareness that children with poor motor abilities are at particular risk for overweight. This cross-sectional study examined the influence of physical activity behaviour on the relationship between motor proficiency and body composition. Participants were 1287 (646 males, 641 females) Grade 6 students in the Physical Health Activity Study project. Height, weight, waist girth, and motor proficiency (Bruininks-Oseretsky Test of Motor Performance BOTMP-SF) were assessed. Physical activity behaviours were also evaluated with a multifaceted approach and reported for school-based, non-school based physical activity, free-time play, and sedentary activities (Participation Questionnaire), and leisure time exercise (Godin-Shephard Leisure Time Exercise Questionnaire GS). Overweight was defined by BMI scores: boys :::20.6-21.2 and <25.1-26.0; girls: ::: 20.7-21.7and <25.4-26.7 and obesity was defined as: boys:::: 25.1-26.0; girls: :::25.4-26.7. Children were classified as case group (CG,::; 10% on BOTMP-SF), borderline case group (BC, > 10% to ::; 20% on BOTMP-SF) or non-case group. Analyses of variance (ANOVAs) uncovered a significant difference in overweight and obesity between the case group and non-case group. Normal-weight children reported higher participation in organized school-sports (intra-mural and inter-school teams). The CG reported significantly lower participation in school sports teams and lower GS results, with a trend towards lower participation in all active pursuits. They also reported a significantly higher duration of television watching and book reading. There were no significant differences between motor proficiency groups by gender, age, nonschool sports, or free-time activity. Multivariate ordinal logistic regression analysis showed that the case group was 10.9 times more likely to be overweight/obese than their peers. No single aspect of physical activity was able to explain the difference in odds ratios for the motor proficiency groups. However, for the entire cohort, children who participated in more organized school sports were less likely to be overweight/obese. These findings confirm that children with low motor proficiency are at significant risk of developing overweight. It is evident that these children have generally attenuated activity levels and heightened levels of sedentary pursuits. School-based activities appear particularly limited, and are the one area where children have near autonomy in their decision to pursue active opportunities. The promotion of school-based programs, specifically intramural sports may be an important aspect in increasing children's overall activity levels. It is also essential to consider the needs of those children with low motor proficiency when designing activity promotion programs. Future research should further explore motor proficiency and overweight/obesity.

The effects of postural threat on cognitive strategies used to maintain upright stance

It is well established that postural threat modifies postural control, although little is known regarding the underlying mechanism(s) responsible. It is possible that changes in postural control under conditions of elevated postural threat result from alterations in cognitive strategies. The purpose of this study was to determine the influence of elevated postural threat on cognitive strategies and to determine the relationship between postural control, psychological, and cognitive measures. It was hypothesized that elevated postural threat would cause a shift to more conscious control of posture. It was also expected that a relationship between fear of falling and postural control would exist that could be explained by changes in conscious control of posture. Forty-eight healthy young adults stood on a force plate at two different surface heights: ground level (LOW) and 3.2m above ground level (HIGH). Center of pressure (COP) summary measures calculated to quantify postural control were the mean position (AP-COP MP), root mean square (AP-COP RMS) and mean power frequency (AP-COP MPF) in the anteriorposterior direction. Trunk sway measures calculated in the pitch direction were trunk angle and trunk velocity. Psychological measures including perceived balance confidence, perceived fear of falling, perceived anxiety, and perceived stability were self reported. As a physiological indicator of anxiety, electrodermal activity was collected. The cognitive strategies assessed were movement reinvestment and attention focus. A modified state-sp-ecific version of the Movement Specific Reinvestment Scale was used to measure conscious motor processing (CMP) and movement self-consciousness (MSC). An attention focus questionnaire was developed to assess the amount of attention directed to internal and external sources. An effect of postural threat on cognitive strategies was observed as participants reported more conscious control and a greater concern or worry about their posture at the HIGH postural threat condition as well as an increased internal and external focus of attention. In addition changes in postural control, psychological, and physiological measures were found. The participants leaned away from the edge of the platform, the frequency of their postural adjustments increased, and the velocity of their trunk movements increased. Participants felt less confident, more fearful, more anxious, and less stable with an accompanying increase in physiological anxiety. Significant correlations between perceived anxiety, AP-COP MP, and cognitive measures revealed a possible relationship that could be mediated by cognitive measures. It was found that with greater conscious motor processing, more movement self-consciousness, and a greater amount of attention focused externally there was a larger shift of the mean position away from the edge of the platform. This thesis provides evidence that postural threat can influence cognitive strategies causing a shift to more conscious control of movement which is associated with leaning away from the edge of the platform. Shifting the position of the body away from the direction of the postural threat may reflect a cognitive strategy to ensure safety in this situation due to the inability to employ a stepping strategy when standing on an elevated platform.

The effects of a 12-week multifactorial exercise and balance training program on balance control in older adults

The current thesis investigated the effects of a 12-week multifactorial exercise and balance training program on balance control in older adults. Participants completed a baseline testing session which included a series of questionnaires, anthropometric measures, and 18 stance and walking tests. Those who were randomly assigned to the exercise group participated in the 12-week training program while the comparison group was asked not to change anything in his/her lifestyle during the 12-week control period, but were invited to participate in the training program after his/her control period. The same testing protocol was repeated after the 12-week period. The results indicated that there were improvements in the time to complete the walking tests but no change in trunk sway in both the exercise and comparison groups. No changes in stance durations or trunk sway were observed. The findings suggest that the current training program showed no significant improvement in balance control in healthy older adults.

Square Root Finding In Graphs

Abstract: Root and root finding are concepts familiar to most branches of mathematics. In graph theory, H is a square root of G and G is the square of H if two vertices x,y have an edge in G if and only if x,y are of distance at most two in H. Graph square is a basic operation with a number of results about its properties in the literature. We study the characterization and recognition problems of graph powers. There are algorithmic and computational approaches to answer the decision problem of whether a given graph is a certain power of any graph. There are polynomial time algorithms to solve this problem for square of graphs with girth at least six while the NP-completeness is proven for square of graphs with girth at most four. The girth-parameterized problem of root fining has been open in the case of square of graphs with girth five. We settle the conjecture that recognition of square of graphs with girth 5 is NP-complete. This result is providing the complete dichotomy theorem for square root finding problem.

Effects of Instruction on Walking and Turning Performance in Individuals with Parkinson's Disease

Parkinson’s disease (PD) is characterized by postural instability and gait impairment. Verbal instructions can reduce postural sway and improve gait performance in PD. For gait, this evidence is limited to unobstructed straight-path walking. As falls in PD often occur when turning, the purpose of this thesis was to determine if instructions can benefit turning performance in this population. Twelve individuals with PD performed two walking tasks (normal walking, walking with a 180 degree turn) under four instruction conditions (no instruction, take big steps, make larger trunk movements, focus on end and/or turn point). Task duration and trunk yaw and roll sway were calculated. In general, the results demonstrated that the instruction to take big steps improved performance for both tasks compared to providing no instruction or externally based instruction. These results suggest that instructions related to step amplitude may facilitate walking and turning performance in PD.

THE ASSOCIATION OF SEQUENCE OF HIRING PRACTICE AND BIOPHYSICAL COMPONENTS IN SCREENING PROBATIONARY FIREFIGHTERS

Variation in hiring procedures occurs within fire service human resource departments. In this study, City 1 and City 2 applicants were required to pass their biophysical assessments prior to being hired as firefighters at the beginning and end of the screening process, respectively. City 1 applicants demonstrated significantly lower resting heart rate (RHR), resting diastolic blood pressure (RDBP), body fat% (BF) and higher z-scores for BF, trunk flexibility (TF) and overall clinical assessment (p<0.05). Regression analysis found that age and conducting the biophysical assessment at the end of the screening process explained poorer biophysical assessment results in BF% (R2=21%), BF z-score (R2=22%), TF z-score (R2=10%) and overall clinical assessment z-score (R2=7%). Each of RHR (OR=1.06, CI=1.01-1.10), RDBP (OR=1.05, CI=1.00-1.11) and BF% (OR=1.20, CI=1.07-1.37) increased the odds of being a City 2 firefighter (p<0.05). Biophysical screening at the end of the hiring process may result in the hiring of a less healthy firefighter.

Can Attention Focus Instructions Reduce the Effects of Fatigue on Balance Control?

Localized muscular fatigue has been identified to have detrimental effects on balance control, an important skill for everyday life. Manipulation of attention focus instructions has been shown to benefit performance of various motor skills including balance and has been found to facilitate endurance during fatiguing tasks. The purpose of this thesis was to determine if the use of attention focus instructions could attenuate the effects of muscular fatigue on balance control. Twenty-four participants performed a balance task (two-legged stance on an unstable platform) before and after a fatigue protocol. Trunk sway, platform excursions, and lower limb muscle activity was measured. Results suggest that use of either internal or external attention focus instructions can reduce the immediate effects of muscular fatigue of the lower limb on balance control as shown through reduced trunk sway and platform excursions. These results have relevance for individuals performing balance tasks in a fatigued state.

Canadian National (CN) records, 1974-1989.

Canadian National Railway Company (CN) was incorporated in 1919 as a Crown Corporation. The company was formed during the period after World War I and integrated two of the country’s largest railroads, Canadian Northern and Grand Trunk. CN is the largest rail network in Canada and the only transcontinental network in North America. As the use of railways declined, CN diversified its activities during the 1970s, becoming involved in telecommunications , hotels and oil exploration. The next decade saw a period of financial stability, however, the 1990s were a period of decreased profitability. As part of a restructuring to alleviate the company’s financial difficulties , it was privatized in 1995.

Validité de construit d’un test d’évaluation de la stabilité lombo-pelvienne, le soulèvement actif de la jambe tendue (SAJT) version objective

Introduction : L’évaluation clinique du contrôle neuromusculaire des muscles du tronc est criante en réhabilitation et en entraînement. L’objectif principal de cette étude a été d’évaluer la reproductibilité intra et inter-évaluateur d’un test clinique le soulèvement actif de la jambe tendue (SAJT) chez une population active et saine. Méthode : Chaque sujet (18 joueurs de tennis) a été testé à deux reprises par 2 physiothérapeutes avec le SAJT. Résultats : La reproductibilité intra-évaluateur s’est avérée élevée à très élevée (ICC = 0.81 à 0.93) tandis la reproductibilité inter-évaluateur s’est avérée cliniquement non viable. Conclusion : À notre connaissance, le SAJT est le premier test clinique reproductible évaluant le contrôle neuromusculaire du tronc avec des compensations musculaires et cinétiques chez des sujets actifs et sains. Une formation plus importante des évaluateurs aurait certainement amélioré la reproductibilité inter-évaluateur.

Développement et validation d’un outil clinique pour l’analyse quantitative de la posture auprès de personnes atteintes d’une scoliose idiopathique

La scoliose idiopathique (SI) est une déformation tridimensionnelle (3D) de la colonne vertébrale et de la cage thoracique à potentiel évolutif pendant la croissance. Cette déformation 3D entraîne des asymétries de la posture. La correction de la posture est un des objectifs du traitement en physiothérapie chez les jeunes atteints d’une SI afin d’éviter la progression de la scoliose, de réduire les déformations morphologiques et leurs impacts sur la qualité de vie. Les outils cliniques actuels ne permettent pas de quantifier globalement les changements de la posture attribuables à la progression de la scoliose ou à l’efficacité des interventions thérapeutiques. L’objectif de cette thèse consiste donc au développement et à la validation d’un nouvel outil clinique permettant l’analyse quantitative de la posture auprès de personnes atteintes d’une SI. Ce projet vise plus spécifiquement à déterminer la fidélité et la validité des indices de posture (IP) de ce nouvel outil clinique et à vérifier leur capacité à détecter des changements entre les positions debout et assise. Suite à une recension de la littérature, 34 IP représentant l’alignement frontal et sagittal des différents segments corporels ont été sélectionnés. L’outil quantitatif clinique d’évaluation de la posture (outil 2D) construit dans ce projet consiste en un logiciel qui permet de calculer les différents IP (mesures angulaires et linéaires). L’interface graphique de cet outil est conviviale et permet de sélectionner interactivement des marqueurs sur les photographies digitales. Afin de vérifier la fidélité et la validité des IP de cet outil, la posture debout de 70 participants âgés entre 10 et 20 ans atteints d'une SI (angle de Cobb: 15º à 60º) a été évaluée à deux occasions par deux physiothérapeutes. Des marqueurs placés sur plusieurs repères anatomiques, ainsi que des points de référence anatomique (yeux, lobes des oreilles, etc.), ont permis de mesurer les IP 2D en utilisant des photographies. Ces mêmes marqueurs et points de référence ont également servi au calcul d’IP 3D obtenus par des reconstructions du tronc avec un système de topographie de surface. Les angles de Cobb frontaux et sagittaux et le déjettement C7-S1 ont été mesurés sur des radiographies. La théorie de la généralisabilité a été utilisée pour déterminer la fidélité et l’erreur standard de la mesure (ESM) des IP de l’outil 2D. Des coefficients de Pearson ont servi à déterminer la validité concomitante des IP du tronc de l’outil 2D avec les IP 3D et les mesures radiographiques correspondantes. Cinquante participants ont été également évalués en position assise « membres inférieurs allongés » pour l’étude comparative de la posture debout et assise. Des tests de t pour échantillons appariés ont été utilisés pour détecter les différences entre les positions debout et assise. Nos résultats indiquent un bon niveau de fidélité pour la majorité des IP de l’outil 2D. La corrélation entre les IP 2D et 3D est bonne pour les épaules, les omoplates, le déjettement C7-S1, les angles de taille, la scoliose thoracique et le bassin. Elle est faible à modérée pour la cyphose thoracique, la lordose lombaire et la scoliose thoraco-lombaire ou lombaire. La corrélation entre les IP 2D et les mesures radiographiques est bonne pour le déjettement C7-S1, la scoliose et la cyphose thoracique. L’outil est suffisamment discriminant pour détecter des différences entre la posture debout et assise pour dix des treize IP. Certaines recommandations spécifiques résultents de ce projet : la hauteur de la caméra devrait être ajustée en fonction de la taille des personnes; la formation des juges est importante pour maximiser la précision de la pose des marqueurs; et des marqueurs montés sur des tiges devraient faciliter l’évaluation des courbures vertébrales sagittales. En conclusion, l’outil développé dans le cadre de cette thèse possède de bonnes propriétés psychométriques et permet une évaluation globale de la posture. Cet outil devrait contribuer à l’amélioration de la pratique clinique en facilitant l’analyse de la posture debout et assise. Cet outil s’avère une alternative clinique pour suivre l’évolution de la scoliose thoracique et diminuer la fréquence des radiographies au cours du suivi de jeunes atteints d’une SI thoracique. Cet outil pourrait aussi être utile pour vérifier l’efficacité des interventions thérapeutiques sur la posture.

Effets de l'application de charges aux membres inférieurs sur le patron de marche des personnes hémiparétiques chroniques

Placer une charge au niveau du membre inférieur est une approche sans fondement scientifique, utilisée par les cliniciens, pour renforcer certains muscles clés de la marche. Cette étude a déterminé les modifications du patron de marche lors de l’ajout d’une charge à la cheville parétique ou non parétique chez des personnes ayant une hémiparésie suite à un accident vasculaire cérébral et a comparé les résultats à ceux d’un groupe témoin. Il est supposé qu’une charge placée à la jambe parétique/non dominante (charge ipsilatérale) augmenterait les efforts (moments et puissance) à la hanche parétique/non dominante lors de l’oscillation et qu’une charge placée controlatéralement augmenterait les efforts lors de la phase d’appui principalement pour les abducteurs de hanche stabilisant le bassin dans le plan frontal. La marche avec et sans charge de cinq individus hémiparétiques chroniques et 5 personnes en santé a été analysée en laboratoire par l’enregistrement des forces de réaction du sol et des mouvements des membres inférieurs. Ces informations ont permis de calculer les paramètres temps-distance, les angles à la hanche parétique/non dominante et au tronc, les moments nets, les puissances et le travail mécanique à la hanche parétique/non dominante. Des tests statistiques non-paramétriques ont servi à déterminer l’effet de la condition, avec charge (ipsi- et controlatérale) ou sans charge et à comparer les résultats entre les deux groupes. L’ajout d’une charge n’a pas modifié la vitesse de marche des sujets. Les phases d’appui et d’oscillation étaient rendus plus symétriques par la charge, même si peu de différences apparaissaient dans le plan sagittal avec ou sans la charge. Dans le plan frontal, le moment abducteur de hanche des sujets hémiparétiques a diminué avec la charge controlatérale, tandis qu'il a augmenté chez les sujets en santé. L’utilisation d’une stratégie posturale ou dynamique au tronc pourrait expliquer la différence de l’effet de la charge sur le moment abducteur à la hanche. Au vu de ces résultats, il est nécessaire de poursuivre l’évaluation de cette approche de renforcement musculaire spécifique à la tâche avant d’en recommander son utilisation.