Scribd Logo
Upload

Welcome to Scribd!

  • 174 views

    Consent Form

    Uploaded by

    Koj Lozada
    1) Physical therapy students are conducting a study to determine if individuals with flat feet present weakness in the hip abductor muscle. 2) Participants aged 14-40 will undergo questionnaires, physical assessments including muscle testing and imaging to evaluate flat feet and hip strength. 3) The study aims to provide understanding on how flat feet may affect hip muscle strength and inform better treatment strategies. All procedures and transportation will be covered by the researchers.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Consent Form

    Uploaded by

    Koj Lozada
    174 views4 pages
    1) Physical therapy students are conducting a study to determine if individuals with flat feet present weakness in the hip abductor muscle. 2) Participants aged 14-40 will undergo questionnaires, physical assessments including muscle testing and imaging to evaluate flat feet and hip strength. 3) The study aims to provide understanding on how flat feet may affect hip muscle strength and inform better treatment strategies. All procedures and transportation will be covered by the researchers.

    Original Description:

    kk

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1) Physical therapy students are conducting a study to determine if individuals with flat feet present weakness in the hip abductor muscle. 2) Participants aged 14-40 will undergo questionnaires, physical assessments including muscle testing and imaging to evaluate flat feet and hip strength. 3) The study aims to provide understanding on how flat feet may affect hip muscle strength and inform better treatment strategies. All procedures and transportation will be covered by the researchers.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    174 views4 pages

    Consent Form

    Uploaded by

    Koj Lozada
    1) Physical therapy students are conducting a study to determine if individuals with flat feet present weakness in the hip abductor muscle. 2) Participants aged 14-40 will undergo questionnaires, physical assessments including muscle testing and imaging to evaluate flat feet and hip strength. 3) The study aims to provide understanding on how flat feet may affect hip muscle strength and inform better treatment strategies. All procedures and transportation will be covered by the researchers.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 4

    APPENDIX I

    Correlation of Gluteus Medius Strength among Flat-Footed Patients Aged 14-40


    College of Affiliation: University of Santo Tomas, College of Rehabilitation Sciences,
    Physical Therapy Department
    Investigators: Bolaos, Jean Atria., Ceniza, Jan Emmanuel., Lozada, Elmer Luigi.,
    Pablo, Ceara Mei., Sinson, Clarice., Tuliao, Timothy John.
    Contact Numbers of Primary Investigators:
    Clarice Sinson: 09275790405 / 9263525
    Jean Atria Bolaos: 09228675667
    Advisers: Fernandez, Roxanne MSPT, PTRP. Nava, Jordan PTRP
    INFORMED CONSENT FORM
    An informed consent form for both males and females aged 14-40 whom we are inviting
    to participate in the experimental study entitled: Correlation of Gluteus Medius Strength
    among Flat Footed Patients aged 14-40.
    Greetings!
    We are graduating Physical Therapy students under the College of Rehabilitation
    Sciences of the University of Santo Tomas and we are currently undertaking a researchstudy on the Correlation of Gluteus Medius Strength among Flat footed patients aged
    14-40.
    Purpose of the Research: To determine if individuals with flat-foot would present
    weakness in hip abductor muscle strength
    Conduct of the Study: Participants will have to answer a questionnaire and assessed
    through Feiss Line, X-ray, Manual Muscle Test, Hand Held Dynamometer, Trendelenburg
    test and to Vicon 2D Motion Analyzer to validate if there are qualified in the study.
    Participant Selection: We are inviting all 14 - 40 years old who are flat-footed to
    participate in the research on the Correlation of Strength of Gluteus medius of FlatFooted Patients in the affiliated centers of the College of Rehabilitation Sciences,
    University of Santo Tomas.
    Voluntary Participation: Your participation in this study is voluntary and may withdraw
    anytime from the study for any reasons. During the course of the study, the participants
    will make at least three meetings with the researchers, two of these will be at St. Martin
    de Porres building in University of Santo Tomas for assessment using Feiss Line,
    Manual Muscle Test, Hand Held Dynamometer, Trendelenburg Test and Vicon 2D Motion
    Analyzer and the other one visits will be at the hospital chosen by the researchers where
    the x-ray would be done to ensure objectivity of results.
    Benefits for the Participants: A better understanding that flat-foot has an effect in the
    weakness of hip abductor muscle strength and this would give off better treatment
    strategies for individuals with flat-foot. The participants would also benefit from having
    free diagnosis by a doctor as to whether they are flat footed or not.

    Risks for the Participants: There is small amount of risk with exposure to radiation but
    the amount of radiation generated during a foot x-ray is too small to cause harm.
    Compensation: All procedures, transportation fees, food and miscellaneous fees needed
    for the study will be provided by the researchers
    Confidentiality: The researchers ensure the confidentiality of the participants identity and
    records. Details that will be collected from you will only be accessible to the researchers
    of the study. Reference numbers rather than your full names will be used in the data
    presentation. The participants will be informed of the results of the research study.
    If you have any questions or concerns about the research or any related matters, you
    may contact Clarice Sinson at 09275790405/ 9263525 or e-mail her at
    clasinson@gmail.com.
    Thank you very much,

    Sincerely yours,
    _______________________
    Clarice Sinson
    09275790405/ 9263525
    clasinson@gmail.com
    Noted by:
    ___________________________
    Roxanne Fernandez, MSPT, PTRP

    ____________________________
    Jordan Nava, PTRP

    CONSENT FORM
    I have read and understood the above information and have been given the
    opportunity to consider and ask questions on the information regarding the involvement
    in the study. I have spoken directly to the investigators of the study who have answered
    to my satisfaction all my questions. I have received a copy of this Participants
    Information and Informed Consent Form. I hereby voluntarily agree to participate.

    Participants Signature:
    ______________

    ________________

    Printed Name of Participant

    Signature of Participant

    _________________________

    ___________________

    Printed Name of Legal Guardian

    Signature of Witness

    __________
    Date
    __________
    Date

    Medical Clearance (if needed only):


    I, undersigned, certify that the best of my knowledge, the participant signing this consent
    form has read above information sheet fully, that this has been carefully explained to
    him/her, and that he/she clearly understands the nature, risks, and benefits of his/her
    participation in the study.

    Physicians Signature:
    ______________________
    _________
    Printed Name of Physician
    Date

    __________________
    Signature of Physician

    CONSENT FORM FOR MINOR


    I have read and understood, with the assistance of my legal guardian, the above information and
    have been given the opportunity to consider and ask questions on the information regarding the
    involvement in this study. I have spoken directly to the investigators of this study who have answered to my
    satisfaction all my questions. I have received a copy of this Participants Information and Informed Consent
    Form. I hereby voluntarily agree to participate.

    Minor-Participants Assent:

    __________________
    Printed Name of Minor

    _______________
    Signature of Minor

    _________________________
    Printed Name of Legal Guardian

    _________________
    Signature of Guardian

    ________
    Date

    ________
    Date

    Witness:
    __________________
    Printed Name of Witness

    _________________
    Signature of Witness

    ________
    Date

    You might also like