PHD, Kent State University, 2022, College of Education, Health and Human Services / School of Health Sciences

Background: Parkinson's disease (PD) is a progressive neurological disorder that results in bradykinesia, tremor, muscle rigidity, and postural instability. In most individuals, high cadence dynamic cycling promotes improvement in motor function and mobility, but there is a need for individually tailored high cadence cycling programs to maximize the treatment effects and minimize the heterogeneity in individual responses. Purpose: The first aim developed an individualized exercise rehabilitation paradigm for people with PD by manipulating entropy of cadence and monitoring the level of effort. The second aim examined the effects of patient-specific adaptive dynamic cycling on motor function, functional mobility, and quality of life in individuals with PD. Method: A total of 11 participants (diagnosed with idiopathic PD), were randomized into either a patient-specific adaptive dynamic cycling (PSADC) or an active control (AC) group. Dynamic cycling settings were optimized for each individual in the PSADC group while the settings were not changed in the AC group. Both groups completed 12 exercise sessions over 4 weeks. Motor function, mobility, and quality of life were measured at the baseline and after 12 sessions using UPDRS Motor III, Timed Up and Go (TUG), and PDQ-39 questionnaires. Results: Patient-specific adaptive dynamic cycling promoted significant improvements in clinical UPDRS Motor III score (Pre: 43.33, Post: 36.67), Kinesia UPDRS Motor III score (Pre: 25.142, Post: 23.833), and TUG duration (Pre: 12.37s, Post: 9.99s), but did not improve quality of life (Pre:16.19, Post:19.24). Individuals in the non-adaptive dynamic cycling did not significantly improve motor function (Pre: 28.60, Post: 29.60), mobility (Pre: 11.23s, Post: 10.85s), or quality of life (Pre:20.08, Post:21.07). Conclusion: Individually tailored exercise prescriptions led to significant improvements in motor function and functional mobility in people with PD.

Committee: Angela Ridgel (Advisor); Hayley Arnold (Committee Member); Jacob Barkley (Committee Member); J. Derek Kingsley (Committee Member) Subjects: Health Sciences; Sports Medicine

Master of Science (MS), Wright State University, 2020, Anatomy

Knee osteoarthritis (KOA), is globally prevalent source of disability for the elderly. This degenerative malady progresses with age and has no cure. It manifests in gait changes and affects overall quality of life. Exercise therapy has been shown to improve knee joint range of motion, stiffness and pain due to KOA. This improvement is due in part to the direct relationship between muscle strength and joint stability. The purpose of this study is to examine how a passive range of motion (ROM) exercises and stretching regimens affect gait-alterations and associated pain from KOA experienced during walking. Nine KOA subjects were recruited from a local orthopedic clinic and the Fel's longitudinal study, with a final sample size of 7 subjects completing the trial. Subjects performed self-paced walking trials before and after a 4-week long, bi-weekly set of passive ROM and stretching exercises. A trained pre-physical therapy student administered the therapy. Data necessary to assess gait before and after the intervention was acquired via standard gait analysis. Participants rated their pain before the intervention, at the fifth trial and after the intervention ended. Subjects experienced significant changes in walking speed, stride-length, cadence, peak knee flexion in stance, peak knee flexion in swing and knee flexion/extension (KFE) ROM in swing. Pain did not significantly decrease, remaining largely unchanged. These data supported our hypothesis that a combination of passive ROM and stretching would result in increased ROM and improved patient gait. Our hypothesis that pain would be significantly decreased was not supported. To improve effectiveness of rehabilitation, further research is needed to elucidate the effects of exercise therapy on osteoarthritis-based pain during ambulation.

Committee: Andrew W. Froehle Ph.D. (Advisor); Drew Pringle Ed.D., FACSM (Committee Member); Kathrin Engisch Ph.D. (Committee Member) Subjects: Anatomy and Physiology

Master of Science, Miami University, 2016, Exercise and Health Studies

The primary aim of this investigation was to determine the relationship between body composition and gross efficiency at various cadences. In 23 subjects (M/F=15/8, age=32.1 (11.1)yrs) body fat: 18.1(7.6)%; body mass: 72.9(7.6) kg; fat free mass: 59.7(8.3) kg; thigh circumference: 50.0(3.1) cm; VO2max: 57.1(9.0) ml/kg/min; and preferred cadence: 89(4.1) rpm) were measured. Efficiency was assessed during two cadence sessions where 3, 5-minute intervals, followed by 5 minutes of rest at a freely chosen cadence. The intervals were set at an intensity of 70% of the power output reached at VO2max. During the interval sessions the participants were instructed to maintain cadences of 80-85-90rpm and 95-100-105 rpm for the first and second sessions, respectively. Fat free mass, body fat %, thigh circumference, and body mass were not significantly associated with cadence efficiency. Preferred cadence was correlated with fat free mass, thigh circumference, and body mass. In agreement with previous studies, cyclists were most efficient at 80 rpm (23.7(1.8)%), and least efficient at 105 rpm (22.2(1.9)%) (p=0.000). It appears that body composition measurements do not influence the cadence at which a cyclist is the most efficient. However, body composition does appear to influence cadence selection and racing strength in competitive cyclists.

Committee: Julie Cousins PhD (Advisor); Ronald Cox PhD (Committee Chair); Randal Claytor PhD (Committee Member) Subjects: Kinesiology

Master of Science, The Ohio State University, 2016, Electrical and Computer Engineering

A phase-locked loop (PLL) frequency synthesizer suitable for multi-band transceivers is proposed in this thesis. The multi band frequency synthesizer uses a Voltage Controlled LC Oscillator that is controlled digitally by a Time to Digital Converter, and an analog loop that determines the fine control voltage. The Frequency Synthesizer is a wide band PLL with a reference of 30 MHz and covers a frequency range of 1667 to 2175 MHz with a low average conversion gain of < 45 MHz/V. A key design feature of this wide band PLL frequency synthesizer is that the VCO tuning switches are controlled digitally and the analog charge pump has a calibration circuit to lock itself in the same time as Digital Tuning. It is characterized by behavioral modeling and is implemented on a 90nm CMOS technology with a 1.2 V supply. The system level design tool CppSim was also explored to conclude the ability to transfer the cadence design points to CppSim and vice versa. Various simulations were done to check the performance of the PLL and the results from system level tool CppSim was verified against transistor level implementation. The simulated phase noise is less than -115 dBc/ Hz at 400 KHz offset and the far out of band phase noise is < -155 dBc / Hz at 20 MHz with 5-bit control. Comparison of this multi-band frequency synthesizer with classical AFC control implemented using counters shows a faster lock-in time relative to 25%, an average of 6.5 dB phase noise difference at 400 KHz and 4 dB improvement at far-out phase noise.

Committee: Steven Bibyk (Advisor); Wladimiro Villarroel (Committee Member) Subjects: Electrical Engineering; Engineering

Doctor of Philosophy, Case Western Reserve University, 2014, EECS - Electrical Engineering

In this dissertation, some novel approaches have been employed to develop a platform for studying new and potentially high-impact therapeutic approaches (e.g. forced exercise or active-assisted cycling) for improving motor function in individuals with Parkinson's disease (PD). These therapeutic methods can readily be implemented and can provide benefits to patients at lower cost and reduced risk. First, with an innovative approach, the complexity of biomechanical and physiological features of forced (tandem) and voluntary (single) cycling was studied using some advanced signal processing methods such as Approximate Entropy (ApEn), Sample Entropy (SaEn), and Spectral Entropy (SpEn). The variability analysis results were used to determine which unique temporal features are positively correlated with measures of the rider's motor skill level. These features were then correlated to motor function improvement in PD patients as measured by the Unified Parkinson's Disease Rating Scale (UPDRS) Motor III using a multiple linear regression (MLR) model. Next, using the results of the first stage, a novel instrumented and automatically controlled cycle (Smart Exercise Bike) was developed to study the associations between PD rider performance and changes in motor function. Smart Bikes were examined with a group of forty-seven PD patients, and the results indicated that the bike imitates tandem cycling in the Dynamic Mode of operation and provides patient benefits similar to tandem cycling. It can also be used to understand how different types of exercise can provide therapeutic benefit to PD patients. Moreover, the Smart Bike can be transformed into a commercial or medical device with data logging and remote access capability for physicians, trainers, and therapists. The data set collected using the Smart Bike will provide a basis for dynamically prescribing customized optimal exercise regimen providing superior therapeutic benefit for individuals with PD in future controlled (open full item for complete abstract)

Committee: Kenneth Loparo (Advisor) Subjects: Engineering

Master of Science in Engineering (MSEgr), Wright State University, 2006, Electrical Engineering

The direct digital synthesizer is a method of signal generation with many benefits. DDS designs are able to switch frequencies very quickly and also tune precisely to many different frequencies with the use of a constant operating frequency. There is a need for a low power, high speed DDS in the form an ASIC design. One major bottleneck in common DDS systems is the slow access time of a ROM. There is also a need for a high speed ROM alternative. This thesis delivers a high speed ASIC Direct Digital Synthesizer which operates at a 1 GHz operating frequency. This high speed DDS design also operated with the low power consumption of fewer than 60 mW. As the results indicate this thesis delivers a possible solution to all of the stated design needs. This implementation could be used by any design that requires an ASIC generated sine wave as an input. This design also implements a unique alternative to the well known ROM bottleneck. This alternative performed at a high operating frequency and also allows for the addition of a pipeline stage, if an even higher operating frequency was desired. Any ASIC design that requires fast frequency hopping could utilize this implementation as well. This design was able to switch frequencies in fewer than 6 ns at the 1 GHz operating frequency. The frequencies this design was able to output ranged between 976.563 kHz and 249.023 MHz.

Committee: Raymond Siferd (Advisor) Subjects: