Pub Date : 2024-02-03DOI: 10.1101/2024.02.01.24301977
Germari Deysel, Mariaan van Aswegen, Mark Kramer
Background Patellofemoral pain (PFP) is a common knee complaint affecting diverse populations both acutely and chronically. Quadriceps muscle weakness is one possible aetiology, but current devices for measuring muscle strength (isokinetic dynamometer and hand-held dynamometers) are frequently too expensive for practitioners, especially in under-resourced settings. There is a need to evaluate a low-cost device to manage rehabilitation of people with PFP. Methods Isometric quadriceps strength of participants aged 18-35 years (total [n = 33], control group [n = 17] and PFP group [n = 16]) were evaluated on an isokinetic dynamometer and a low-cost load cell at baseline and after an 8-week non-standardised intervention for validity scores. Results The load cell showed high absolute and relative reliability (intraclass correlation coefficient = 0.89-0.99; typical error of measurement = 3.9-10.4%). Clinically meaningful difference scores (12.2-45 Nm) were greater than the typical error of measurement, implying sufficient sensitivity of the load cell to measure true changes in isometric quadricep strength. Strong to very strong correlations were evident between the load cell and isokinetic dynamometer torque measurements (r = 0.88-0.90, SEE = 0.05-0.07 Nm), but slope values (β = 0.65-0.77) indicated that torque from the load cell was typically lower than that obtained from the isokinetic dynamometer. An average systematic bias of 16.3-28.8 Nm was evident in favour of the isokinetic dynamometer, with no statistically significant between-group differences being noted between the baseline and follow-up testing. Conclusion The load cell is a reliable instrument, sensitive enough to detect clinically meaningful differences in quadriceps strength in healthy individuals and those with PFP. The load cell lacks validity and cannot replace isokinetic dynamometry. Given the low cost and excellent reliability, the load cell can be a valuable tool to assess quadriceps muscle deficits and track rehabilitation progress in people with PFP.
{"title":"Assessing quadriceps strength in patellofemoral pain patients: A study on the reliability and validity of a low-cost load-cell for clinical practice","authors":"Germari Deysel, Mariaan van Aswegen, Mark Kramer","doi":"10.1101/2024.02.01.24301977","DOIUrl":"https://doi.org/10.1101/2024.02.01.24301977","url":null,"abstract":"Background\u0000Patellofemoral pain (PFP) is a common knee complaint affecting diverse populations both acutely and chronically. Quadriceps muscle weakness is one possible aetiology, but current devices for measuring muscle strength (isokinetic dynamometer and hand-held dynamometers) are frequently too expensive for practitioners, especially in under-resourced settings. There is a need to evaluate a low-cost device to manage rehabilitation of people with PFP.\u0000Methods\u0000Isometric quadriceps strength of participants aged 18-35 years (total [n = 33], control group [n = 17] and PFP group [n = 16]) were evaluated on an isokinetic dynamometer and a low-cost load cell at baseline and after an 8-week non-standardised intervention for validity scores. Results\u0000The load cell showed high absolute and relative reliability (intraclass correlation coefficient = 0.89-0.99; typical error of measurement = 3.9-10.4%). Clinically meaningful difference scores (12.2-45 Nm) were greater than the typical error of measurement, implying sufficient sensitivity of the load cell to measure true changes in isometric quadricep strength. Strong to very strong correlations were evident between the load cell and isokinetic dynamometer torque measurements (r = 0.88-0.90, SEE = 0.05-0.07 Nm), but slope values (β = 0.65-0.77) indicated that torque from the load cell was typically lower than that obtained from the isokinetic dynamometer. An average systematic bias of 16.3-28.8 Nm was evident in favour of the isokinetic dynamometer, with no statistically significant between-group differences being noted between the baseline and follow-up testing.\u0000Conclusion\u0000The load cell is a reliable instrument, sensitive enough to detect clinically meaningful differences in quadriceps strength in healthy individuals and those with PFP. The load cell lacks validity and cannot replace isokinetic dynamometry. Given the low cost and excellent reliability, the load cell can be a valuable tool to assess quadriceps muscle deficits and track rehabilitation progress in people with PFP.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139669716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.1101/2024.01.31.24301806
Giacomo Di Raimondo, Miel Willems, Bryce Adrian Killen, Sara Havashinezhadian, Katia Turcot, Benedicte Vanwanseele, Ilse Jonkers
Osteoarthritis (OA) is a prevalent musculoskeletal condition leading to functional limitations, especially among the elderly. Current treatments focus on pain relief and functional improvement, however there is a lack of approaches which slow disease progression. A promising approach focusses on reducing knee joint loading, as excessive loading contributes to knee OA progression. This study explores kinematic variations in the knee OA population, utilizing principal component analysis (PCA) to examine gait variations (primitives) in both healthy individuals and those with knee osteoarthritis (KOA) and their implications for knee joint loading. The KOA population exhibited 14 modes of variation representing 95% of the cumulative variance, compared to 20 in the healthy population, indicating lower variability with KOA. The relation between identified gait primitives and knee loading parameters, revealed complex relationships. Surprisingly, modes with the largest kinematic variations did not consistently correspond to the highest variations in knee loading parameters revealing degrees of freedom which may have a larger role in determining joint loading. Moreover, potential gait-retraining strategies for KOA, associating specific kinematic combinations with altered knee loading were identified. The results showed a good agreement with previously applied strategies. However, this study highlights the importance of analyzing whole-body kinematics for effective gait retraining, as opposed to focusing on one single joint variation. The study's insights contribute to understanding the intricate interplay between gait pattern variations and knee joint loading changes in healthy and KOA populations, offering practical applications for guiding interventions and estimating loading parameters.
骨关节炎（OA）是一种常见的肌肉骨骼疾病，会导致功能受限，尤其是在老年人中。目前的治疗方法侧重于缓解疼痛和改善功能，但缺乏减缓疾病进展的方法。减少膝关节负荷是一种很有前景的方法，因为过度负荷会导致膝关节 OA 的恶化。本研究探讨了膝关节 OA 患者的运动学变化，利用主成分分析法（PCA）研究了健康人和膝关节骨性关节炎（KOA）患者的步态变化（基元）及其对膝关节负荷的影响。KOA 患者表现出 14 种变异模式，占累积变异的 95%，而健康患者为 20 种，表明 KOA 患者的变异性较低。已确定的步态基元与膝关节负荷参数之间的关系显示出复杂的关系。令人惊讶的是，运动学变异最大的模式与膝关节负荷参数的最大变异并不一致，这揭示了在决定关节负荷方面可能有更大作用的自由度。此外，研究还发现了针对 KOA 的潜在步态再训练策略，将特定的运动学组合与膝关节负荷的改变联系起来。结果表明，这些策略与之前应用的策略非常吻合。不过，这项研究强调了分析全身运动学对有效步态再训练的重要性，而不是只关注单一关节的变化。该研究的见解有助于理解健康和 KOA 群体中步态模式变化与膝关节负荷变化之间错综复杂的相互作用，为指导干预措施和估算负荷参数提供了实际应用。
{"title":"Population-based analysis of knee joint loading in a knee osteoarthritis cohort: the impact of PCA-derived gait kinematic variations on estimated medial knee contact forces","authors":"Giacomo Di Raimondo, Miel Willems, Bryce Adrian Killen, Sara Havashinezhadian, Katia Turcot, Benedicte Vanwanseele, Ilse Jonkers","doi":"10.1101/2024.01.31.24301806","DOIUrl":"https://doi.org/10.1101/2024.01.31.24301806","url":null,"abstract":"Osteoarthritis (OA) is a prevalent musculoskeletal condition leading to functional limitations, especially among the elderly. Current treatments focus on pain relief and functional improvement, however there is a lack of approaches which slow disease progression. A promising approach focusses on reducing knee joint loading, as excessive loading contributes to knee OA progression. This study explores kinematic variations in the knee OA population, utilizing principal component analysis (PCA) to examine gait variations (primitives) in both healthy individuals and those with knee osteoarthritis (KOA) and their implications for knee joint loading. The KOA population exhibited 14 modes of variation representing 95% of the cumulative variance, compared to 20 in the healthy population, indicating lower variability with KOA. The relation between identified gait primitives and knee loading parameters, revealed complex relationships. Surprisingly, modes with the largest kinematic variations did not consistently correspond to the highest variations in knee loading parameters revealing degrees of freedom which may have a larger role in determining joint loading. Moreover, potential gait-retraining strategies for KOA, associating specific kinematic combinations with altered knee loading were identified. The results showed a good agreement with previously applied strategies. However, this study highlights the importance of analyzing whole-body kinematics for effective gait retraining, as opposed to focusing on one single joint variation. The study's insights contribute to understanding the intricate interplay between gait pattern variations and knee joint loading changes in healthy and KOA populations, offering practical applications for guiding interventions and estimating loading parameters.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139669724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-30DOI: 10.1101/2024.01.29.24301948
Niko Fullmer, Hannah Cone, Jeanette Gumarang, Emily Kieffer, Soyoung Esther Bae, Emily R. Rosario
Objective: This study explores the accessibility of beauty products for individuals with upper extremity disabilities. Methods: Participants with varied upper extremity impairments used Rare Beauty makeup products over two weeks. Assessments of hand function and questionnaires evaluated usability and satisfaction. Results: Product features like bottle shape, cap design, and texture significantly influenced usability for those with hand and arm impairments. Notably, individuals with fine motor skill impairments reported easier gripping with larger bottle sizes and ease of opening with cap enhancements. The unique product shape and enhanced caps were also found to be more accessible for participants across all ability levels. Overall, the products were well-received, with most participants finding them comfortable and user-friendly. Conclusions: The study emphasizes the need for inclusive design in the beauty industry, catering to those with upper extremity disabilities. It reveals the importance of ergonomic and adaptable product features to enhance usability and accessibility.
{"title":"Exploring Beauty Product Accessibility for Individuals with Upper Extremity Disabilities","authors":"Niko Fullmer, Hannah Cone, Jeanette Gumarang, Emily Kieffer, Soyoung Esther Bae, Emily R. Rosario","doi":"10.1101/2024.01.29.24301948","DOIUrl":"https://doi.org/10.1101/2024.01.29.24301948","url":null,"abstract":"Objective: This study explores the accessibility of beauty products for individuals with upper extremity disabilities. Methods: Participants with varied upper extremity impairments used Rare Beauty makeup products over two weeks. Assessments of hand function and questionnaires evaluated usability and satisfaction. Results: Product features like bottle shape, cap design, and texture significantly influenced usability for those with hand and arm impairments. Notably, individuals with fine motor skill impairments reported easier gripping with larger bottle sizes and ease of opening with cap enhancements. The unique product shape and enhanced caps were also found to be more accessible for participants across all ability levels. Overall, the products were well-received, with most participants finding them comfortable and user-friendly. Conclusions: The study emphasizes the need for inclusive design in the beauty industry, catering to those with upper extremity disabilities. It reveals the importance of ergonomic and adaptable product features to enhance usability and accessibility.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139646130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-30DOI: 10.1101/2024.01.26.24301687
Maryam Sadeghi, Thomas Bristow, Sodiq Fakorede, Ke Liao, Jacqueline A Palmer, Kelly Lyons, Rajesh Pahwa, Chun-Kai Huang, Abiodun Akinwuntan, Hannes Devos
Abstract Aims: Balance requires the cortical control of visual, somatosensory, and vestibular inputs. The aim of this cross-sectional study was to compare the contributions of each of these systems on postural control and cortical activity using a sensory reweighting approach between participants with Parkinsons disease (PD) and controls. Methods: Ten participants with PD (age: 72 plus or minus 9; 3 women; Hoehn & Yahr: 2 [1.5 to 2.50]) and 11 controls (age: 70 plus or minus 3; 4 women) completed a sensory organization test in virtual reality (VR-SOT) while cortical activity was being recorded using electroencephalography (EEG). Conditions 1 to 3 were completed on a stable platform; conditions 4 to 6 on a foam. Conditions 1 and 4 were done with eyes open; conditions 2 and 5 in a darkened VR environment; and conditions 3 and 6 in a moving VR environment. Linear mixed models were used to evaluate changes in center of pressure (COP) displacement and EEG alpha and theta/beta ratio power between the two groups across the postural control conditions. Condition 1 was used as reference in all analyses. Results: Participants with PD showed greater COP displacement than controls in the anteroposterior (AP) direction when relying on vestibular input (condition 5; p<0.0001). The mediolateral (ML) COP sway was greater in PD than in controls when relying on the somatosensory (condition 2; p = 0.03), visual (condition 4; p = 0.002), and vestibular (condition 5; p < 0.0001) systems. Participants with PD exhibited greater alpha power compared to controls when relying on visual input (condition 2; p = 0.003) and greater theta/beta ratio power when relying on somatosensory input (condition 4; p = 0.001). Conclusions: PD affects reweighting of postural control, exemplified by greater COP displacement and increased cortical activity. Further research is needed to establish the temporal dynamics between cortical activity and COP displacement.
{"title":"The Effect of Sensory Reweighting on Postural Control and Cortical Activity in Parkinsons Disease","authors":"Maryam Sadeghi, Thomas Bristow, Sodiq Fakorede, Ke Liao, Jacqueline A Palmer, Kelly Lyons, Rajesh Pahwa, Chun-Kai Huang, Abiodun Akinwuntan, Hannes Devos","doi":"10.1101/2024.01.26.24301687","DOIUrl":"https://doi.org/10.1101/2024.01.26.24301687","url":null,"abstract":"Abstract\u0000Aims: Balance requires the cortical control of visual, somatosensory, and vestibular inputs. The aim of this cross-sectional study was to compare the contributions of each of these systems on postural control and cortical activity using a sensory reweighting approach between participants with Parkinsons disease (PD) and controls.\u0000Methods: Ten participants with PD (age: 72 plus or minus 9; 3 women; Hoehn & Yahr: 2 [1.5 to 2.50]) and 11 controls (age: 70 plus or minus 3; 4 women) completed a sensory organization test in virtual reality (VR-SOT) while cortical activity was being recorded using electroencephalography (EEG). Conditions 1 to 3 were completed on a stable platform; conditions 4 to 6 on a foam. Conditions 1 and 4 were done with eyes open; conditions 2 and 5 in a darkened VR environment; and conditions 3 and 6 in a moving VR environment. Linear mixed models were used to evaluate changes in center of pressure (COP) displacement and EEG alpha and theta/beta ratio power between the two groups across the postural control conditions. Condition 1 was used as reference in all analyses.\u0000Results: Participants with PD showed greater COP displacement than controls in the anteroposterior (AP) direction when relying on vestibular input (condition 5; p<0.0001). The mediolateral (ML) COP sway was greater in PD than in controls when relying on the somatosensory (condition 2; p = 0.03), visual (condition 4; p = 0.002), and vestibular (condition 5; p < 0.0001) systems. Participants with PD exhibited greater alpha power compared to controls when relying on visual input (condition 2; p = 0.003) and greater theta/beta ratio power when relying on somatosensory input (condition 4; p = 0.001).\u0000Conclusions: PD affects reweighting of postural control, exemplified by greater COP displacement and increased cortical activity. Further research is needed to establish the temporal dynamics between cortical activity and COP displacement.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139579182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-30DOI: 10.1101/2024.01.29.24301976
Dhaval Pawani, Abraham M Joshua, Akshatha Nayak, Vijayakumar Palaniswamy, Prasanna Mithra, Ashish John Prabhakar, Sampath Kumar Amaravadi
Objective : This study aimed to develop and concurrently validate a simple, resource-efficient, and time-efficient bedside tool based on day-to-day movement tasks for evaluating upper limb function in stroke survivors. Methods: The study’s qualitative and cross-sectional component was conducted in 2 stages. At the initial stage, a relevant literature review was carried out to conceptualize and define the theoretical framework of day-to-day movement tasks, in evaluating upper limb function. Subsequently, an initial item pool of 18 upper limb and hand movements was developed. A Delphi method was employed to verify content validity of the initial 18-item scale using an expert consensus panel of 6 subject matter experts (three neurologists, two physiotherapists, and 1 occupation therapist). At the first round, 4 items were excluded using expert panel consensus method. During the second round of the content validation phase, the remaining 14-item scale was revised and refined to a final 12-item scale by the expert panel using a 5-point Likert rating scale. A score of 2 or below by at least two experts on a 5-point Likert scale was used as the criterion to modify or remove the components. During the second stage, the final 12-item bedside upper limb evaluation tool (BUFET) scale underwent concurrent validation using purposive sampling of 25 stroke survivors. Concurrent validity was assessed by correlating the BUFET score with Wolf Motor Function (WMT) scores using Spearman's correlation coefficient and internal consistency was evaluated through Cronbach’s alpha. Results: Concurrent validity and internal consistency of the scale were supported by a high correlation coefficient (r = 0.937; p<0.001) with WMFT and high Cronbach’s alpha (0.948). Conclusions: The newly developed BUFET was found to be a valid and reliable bedside tool in the evaluation of upper limb functions and can be administered in a resource and time-efficient manner.
{"title":"Development and Validation of a Bedside Scale for Assessing Upper Limb Function Following Stroke: A Methodological Study","authors":"Dhaval Pawani, Abraham M Joshua, Akshatha Nayak, Vijayakumar Palaniswamy, Prasanna Mithra, Ashish John Prabhakar, Sampath Kumar Amaravadi","doi":"10.1101/2024.01.29.24301976","DOIUrl":"https://doi.org/10.1101/2024.01.29.24301976","url":null,"abstract":"Objective : This study aimed to develop and concurrently validate a simple, resource-efficient, and time-efficient bedside tool based on day-to-day movement tasks for evaluating upper limb function in stroke survivors.\u0000Methods: The study’s qualitative and cross-sectional component was conducted in 2 stages. At the initial stage, a relevant literature review was carried out to conceptualize and define the theoretical framework of day-to-day movement tasks, in evaluating upper limb function. Subsequently, an initial item pool of 18 upper limb and hand movements was developed. A Delphi method was employed to verify content validity of the initial 18-item scale using an expert consensus panel of 6 subject matter experts (three neurologists, two physiotherapists, and 1 occupation therapist). At the first round, 4 items were excluded using expert panel consensus method. During the second round of the content validation phase, the remaining 14-item scale was revised and refined to a final 12-item scale by the expert panel using a 5-point Likert rating scale. A score of 2 or below by at least two experts on a 5-point Likert scale was used as the criterion to modify or remove the components. During the second stage, the final 12-item bedside upper limb evaluation tool (BUFET) scale underwent concurrent validation using purposive sampling of 25 stroke survivors. Concurrent validity was assessed by correlating the BUFET score with Wolf Motor Function (WMT) scores using Spearman's correlation coefficient and internal consistency was evaluated through Cronbach’s alpha.\u0000Results: Concurrent validity and internal consistency of the scale were supported by a high correlation coefficient (r = 0.937; p<0.001) with WMFT and high Cronbach’s alpha (0.948).\u0000Conclusions: The newly developed BUFET was found to be a valid and reliable bedside tool in the evaluation of upper limb functions and can be administered in a resource and time-efficient manner.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139645991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-30DOI: 10.1101/2024.01.29.24301957
Saniya Waghmare, Alicen A Whitaker-Hilbig, Mark Chertoff, Sandra A. Billinger
Autonomic nervous system (ANS) activity causes acute variations in the blood pressure. Blood pressure responds to high intensity interval exercise (HIIE) repeatedly during alternating intensities, however, ANS response to the changing intensities of HIIE is unknown. We characterized the response of beat-to-beat blood pressure variability (BTB BPV) to an acute bout of HIIE using coefficient of variation (CoV) and spectral low frequency [LF], and high frequency [HF] domains. Our hypotheses were mean arterial pressure BTB BPV, would increase during 1) high intensity and 2) active recovery of HIIE compared to baseline (BL). BTB BPV would reduce during 1) cool down 2) post HIIE 3) 30 minutes post HIIE compared to BL in young adults. HIIE included bouts of 1-minute high-intensity separated by 1-minute recovery (approx 70% and 10% estimated Wattmax) for total of 10 minutes on a recumbent stepper. A secondary analysis was performed using twenty-one datasets of young individuals (age 25[SD 1.5], 48% female). During high intensity, LF and HF increased compared to BL (p < 0.05) indicating increased sympathetic activity and breathing. During active recovery, LF and HF remained elevated above BL and were greater than during high intensity (p = 0.02). Sympathetic activity reduced back to BL immediately post HIIE but returned to being higher than BL at 30 minutes after HIIE (p=0.001). BTB BPV CoV also increased during HIIE compared to BL (p<0.05). Results suggest that young healthy individuals have increased BTB BPV during HIIE suggesting cardiovascular system responds to ANS fluctuations during changing exercise intensity.
{"title":"Blood Pressure Variability and Autonomic Response to an Acute Bout of High Intensity Interval Exercise in Healthy Young Adults","authors":"Saniya Waghmare, Alicen A Whitaker-Hilbig, Mark Chertoff, Sandra A. Billinger","doi":"10.1101/2024.01.29.24301957","DOIUrl":"https://doi.org/10.1101/2024.01.29.24301957","url":null,"abstract":"Autonomic nervous system (ANS) activity causes acute variations in the blood pressure. Blood pressure responds to high intensity interval exercise (HIIE) repeatedly during alternating intensities, however, ANS response to the changing intensities of HIIE is unknown. We characterized the response of beat-to-beat blood pressure variability (BTB BPV) to an acute bout of HIIE using coefficient of variation (CoV) and spectral low frequency [LF], and high frequency [HF] domains. Our hypotheses were mean arterial pressure BTB BPV, would increase during 1) high intensity and 2) active recovery of HIIE compared to baseline (BL). BTB BPV would reduce during 1) cool down 2) post HIIE 3) 30 minutes post HIIE compared to BL in young adults. HIIE included bouts of 1-minute high-intensity separated by 1-minute recovery (approx 70% and 10% estimated Wattmax) for total of 10 minutes on a recumbent stepper. A secondary analysis was performed using twenty-one datasets of young individuals (age 25[SD 1.5], 48% female). During high intensity, LF and HF increased compared to BL (p < 0.05) indicating increased sympathetic activity and breathing. During active recovery, LF and HF remained elevated above BL and were greater than during high intensity (p = 0.02). Sympathetic activity reduced back to BL immediately post HIIE but returned to being higher than BL at 30 minutes after HIIE (p=0.001). BTB BPV CoV also increased during HIIE compared to BL (p<0.05). Results suggest that young healthy individuals have increased BTB BPV during HIIE suggesting cardiovascular system responds to ANS fluctuations during changing exercise intensity.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139579043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.1101/2024.01.28.24301892
Chantel Ostler, Alex Dickinson, Cheryl Metcalf, Maggie Donovan-Hall
Background Little is known about which outcome domains characterise meaningful recovery following prosthetic rehabilitation and should be measured. Our previous qualitative work developed a conceptual model of outcome domains which are meaningful to patients. This qualitative synthesis aims to develop that model by exploring views and experiences of recovery captured in the limb loss literature, and use these to produce a second iteration of the model describing outcome domains of importance following prosthetic rehabilitation from the patient's perspective. Methods Systematic searches were conducted using CINAHL, Psychinfo and Web of Science from 2011 to early 2023. Studies with a qualitative design focusing on views and experiences of lower limb prosthetic users were eligible for inclusion. Quality was assessed using the CASP tool. 'Best Fit' framework synthesis was used to synthesise the evidence and develop the conceptual model. Results 40 studies were included, describing the experiences of 539 participants. Data supported the pre-existing conceptual model and led to development of four of the five domains. The newly named ECLIPSE model describes meaningful outcome domains as 1) Being able to participate in important activities and roles, 2) Participating in the way I want to, 3) My prosthesis works for me, 4) If I am in pain, I can manage it, and 5) I am able to accept my new normal. Studies came from 15 countries showing good coverage of high-income settings. Few participants from low-and-middle-income countries were included, it is unclear if the ECLIPSE model describes outcome domains of importance in these settings. Conclusions This synthesis provides a rigorous foundation for understanding outcome domains of importance following lower limb prosthetic rehabilitation from the patient's perspective. The ECLIPSE model is an accessible representation of recovery which could direct rehabilitation programmes, as well as inform the evaluation of prosthetic care through the selection of outcome measures.
{"title":"Development of the ECLIPSE model of meaningful outcome domains following lower limb amputation and prosthetic rehabilitation, through systematic review and best fit framework synthesis","authors":"Chantel Ostler, Alex Dickinson, Cheryl Metcalf, Maggie Donovan-Hall","doi":"10.1101/2024.01.28.24301892","DOIUrl":"https://doi.org/10.1101/2024.01.28.24301892","url":null,"abstract":"Background\u0000Little is known about which outcome domains characterise meaningful recovery following prosthetic rehabilitation and should be measured. Our previous qualitative work developed a conceptual model of outcome domains which are meaningful to patients. This qualitative synthesis aims to develop that model by exploring views and experiences of recovery captured in the limb loss literature, and use these to produce a second iteration of the model describing outcome domains of importance following prosthetic rehabilitation from the patient's perspective. Methods\u0000Systematic searches were conducted using CINAHL, Psychinfo and Web of Science from 2011 to early 2023. Studies with a qualitative design focusing on views and experiences of lower limb prosthetic users were eligible for inclusion. Quality was assessed using the CASP tool. 'Best Fit' framework synthesis was used to synthesise the evidence and develop the conceptual model. Results 40 studies were included, describing the experiences of 539 participants. Data supported the pre-existing conceptual model and led to development of four of the five domains. The newly named ECLIPSE model describes meaningful outcome domains as 1) Being able to participate in important activities and roles, 2) Participating in the way I want to, 3) My prosthesis works for me, 4) If I am in pain, I can manage it, and 5) I am able to accept my new normal. Studies came from 15 countries showing good coverage of high-income settings. Few participants from low-and-middle-income countries were included, it is unclear if the ECLIPSE model describes outcome domains of importance in these settings. Conclusions\u0000This synthesis provides a rigorous foundation for understanding outcome domains of importance following lower limb prosthetic rehabilitation from the patient's perspective. The ECLIPSE model is an accessible representation of recovery which could direct rehabilitation programmes, as well as inform the evaluation of prosthetic care through the selection of outcome measures.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139579061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.1101/2024.01.24.24301737
Yael Arbel, Yoav Gimmon, Liora Shmueli
Objective: To evaluate the accuracy, completeness, and explanations provided by ChatGPT in response to multiple-choice questions related to vestibular rehabilitation. Study Design: The study was conducted among 30 physical therapists professionals experienced with vestibular rehabilitation and 30 physical therapy students. They were asked to complete a Vestibular Knowledge Test consisting of 20 multiple-choice questions categorized into three groups: (1) Clinical Knowledge, (2) Basic Clinical Practice, and (3) Clinical Reasoning. Additionally, in May 2023, ChatGPT was tasked with answering the same 20 VKT questions and providing rationales for its answers. Three expert board-certified otoneurologists evaluated independently the accuracy of each ChatGPT response on a 4-level scale. Results: ChatGPT correctly answered 14 of the 20 multiple-choice questions (70%). It excelled in Clinical Knowledge (100%) but struggled in Clinical Reasoning (50%). According to three otoneurologic experts, ChatGPT's accuracy was "comprehensive" for 9 of the 20 questions (45%), while 5 (25%) were "completely incorrect". ChatGPT provided "comprehensive" responses in 50% of Clinical Knowledge and Basic Clinical Practice questions, but only 25% in Clinical Reasoning. Conclusion: Caution is advised when using the current version of ChatGPT due to its limited accuracy in clinical reasoning. While it provides accurate responses concerning Clinical Knowledge, its reliance on web information may lead to inconsistencies. Healthcare professionals should carefully formulate questions and be aware of the potential influence of the online prevalence of information on ChatGPT's responses. Combining clinical expertise and guidelines with ChatGPT can maximize benefits while mitigating limitations.
{"title":"Unveiling the Potential: ChatGPT's Impact on Vestibular Rehabilitation Education - Trust, Learning, and Value","authors":"Yael Arbel, Yoav Gimmon, Liora Shmueli","doi":"10.1101/2024.01.24.24301737","DOIUrl":"https://doi.org/10.1101/2024.01.24.24301737","url":null,"abstract":"Objective: To evaluate the accuracy, completeness, and explanations provided by ChatGPT in response to multiple-choice questions related to vestibular rehabilitation.\u0000Study Design: The study was conducted among 30 physical therapists professionals experienced with vestibular rehabilitation and 30 physical therapy students. They were asked to complete a Vestibular Knowledge Test consisting of 20 multiple-choice questions categorized into three groups: (1) Clinical Knowledge, (2) Basic Clinical Practice, and (3) Clinical Reasoning. Additionally, in May 2023, ChatGPT was tasked with answering the same 20 VKT questions and providing rationales for its answers. Three expert board-certified otoneurologists evaluated independently the accuracy of each ChatGPT response on a 4-level scale.\u0000Results: ChatGPT correctly answered 14 of the 20 multiple-choice questions (70%). It excelled in Clinical Knowledge (100%) but struggled in Clinical Reasoning (50%). According to three otoneurologic experts, ChatGPT's accuracy was \"comprehensive\" for 9 of the 20 questions (45%), while 5 (25%) were \"completely incorrect\". ChatGPT provided \"comprehensive\" responses in 50% of Clinical Knowledge and Basic Clinical Practice questions, but only 25% in Clinical Reasoning.\u0000Conclusion: Caution is advised when using the current version of ChatGPT due to its limited accuracy in clinical reasoning. While it provides accurate responses concerning Clinical Knowledge, its reliance on web information may lead to inconsistencies. Healthcare professionals should carefully formulate questions and be aware of the potential influence of the online prevalence of information on ChatGPT's responses. Combining clinical expertise and guidelines with ChatGPT can maximize benefits while mitigating limitations.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"252 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139579058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-24DOI: 10.1101/2024.01.24.24301716
Elise Milosevich, Andrea Kusec, Sarah T. Pendlebury, Nele Demeyere
Purpose To identify which acute and 6-month domain-specific cognitive impairments impact mood functioning, participation, and stroke-related quality of life 6 months after stroke. Materials and Methods A prospective cohort of 430 stroke survivors completed the Oxford Cognitive Screen (OCS) acutely and 6 months post-stroke. Participants completed the Stroke Impact Scale (SIS) and Hospital Depression and Anxiety Scale (HADS) at 6 months. Multivariable regression analyses assessed whether severity of, and domain-specific, cognitive impairment acutely and at 6 months was associated with composite 6-month SIS scores, each SIS subscale, and HADS scores. Results Increased severity of cognitive impairment acutely and at 6 months was associated with lower 6-month SIS composite scores independent of age, sex, education years, and stroke severity (both p<0.001). Domain-specific impairments in memory (p<0.001) and attention (p=0.002) acutely, and language (p<0.001), memory (p=0.001) and number processing (p=0.006) at 6 months showed the strongest associations with worse SIS composite scores. Severity of acute and 6-month cognitive impairment was associated with poorer functioning in each SIS subscale, as well as greater levels of depression (acute p=0.021, 6-months p<0.001), but not anxiety (p=0.174, p=0.129). Conclusions Both acute and 6-month domain-specific cognitive impairments, particularly in memory, were found to negatively impact overall functional and mood outcomes 6 months post-stroke.
{"title":"Domain-specific Cognitive Impairments, Mood and Quality of Life 6 Months After Stroke","authors":"Elise Milosevich, Andrea Kusec, Sarah T. Pendlebury, Nele Demeyere","doi":"10.1101/2024.01.24.24301716","DOIUrl":"https://doi.org/10.1101/2024.01.24.24301716","url":null,"abstract":"Purpose\u0000To identify which acute and 6-month domain-specific cognitive impairments impact mood functioning, participation, and stroke-related quality of life 6 months after stroke. Materials and Methods\u0000A prospective cohort of 430 stroke survivors completed the Oxford Cognitive Screen (OCS) acutely and 6 months post-stroke. Participants completed the Stroke Impact Scale (SIS) and Hospital Depression and Anxiety Scale (HADS) at 6 months. Multivariable regression analyses assessed whether severity of, and domain-specific, cognitive impairment acutely and at 6 months was associated with composite 6-month SIS scores, each SIS subscale, and HADS scores. Results\u0000Increased severity of cognitive impairment acutely and at 6 months was associated with lower 6-month SIS composite scores independent of age, sex, education years, and stroke severity (both p<0.001). Domain-specific impairments in memory (p<0.001) and attention (p=0.002) acutely, and language (p<0.001), memory (p=0.001) and number processing (p=0.006) at 6 months showed the strongest associations with worse SIS composite scores. Severity of acute and 6-month cognitive impairment was associated with poorer functioning in each SIS subscale, as well as greater levels of depression (acute p=0.021, 6-months p<0.001), but not anxiety (p=0.174, p=0.129). Conclusions\u0000Both acute and 6-month domain-specific cognitive impairments, particularly in memory, were found to negatively impact overall functional and mood outcomes 6 months post-stroke.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139558891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-23DOI: 10.1101/2024.01.22.24301473
Sofia Wöhrstein, Michael Bressler, Lisa Röhrig, Cosima Prahm, Hans-Otto Karnath
Pusher syndrome is a disorder of postural control after stroke. Patients show a mismatch in their perception of (almost preserved) visual and (pathologically tilted) postural verticality. In order to reduce this mismatch, we developed a novel head-mounted Tilted Reality Device (TRD). It presents patients visual footage of their actual surroundings but tilted to one side rather than upright. We investigated its usability and possible limitations in its use for the treatment of pusher patients in two samples of healthy participants with an average age of 26.4 years and 63.9 years respectively. Individuals from both age groups showed similar levels of tolerance to prolonged exposure to the tilted visual environment for an average of 40.4 minutes while walking around in the hospital. The TRD was found to be comfortable and not frustrating whilst wearing, but somewhat challenging in terms of technical handling, particularly for older participants. At the end of the maximally tolerated exposure time participants of both groups experienced some feelings of discomfort, like dizziness or increased stomach awareness, which disappeared rapidly after terminating TRD exposure. Our TRD appears to be a practical device especially for an older population, like pusher patients. While users must be aware of the possibility of side effects, these should be balanced against the benefits of future use for rehabilitation purposes.
{"title":"A head-mounted Tilted Reality Device for the treatment of pusher syndrome: A usability study","authors":"Sofia Wöhrstein, Michael Bressler, Lisa Röhrig, Cosima Prahm, Hans-Otto Karnath","doi":"10.1101/2024.01.22.24301473","DOIUrl":"https://doi.org/10.1101/2024.01.22.24301473","url":null,"abstract":"Pusher syndrome is a disorder of postural control after stroke. Patients show a mismatch in their perception of (almost preserved) visual and (pathologically tilted) postural verticality. In order to reduce this mismatch, we developed a novel head-mounted Tilted Reality Device (TRD). It presents patients visual footage of their actual surroundings but tilted to one side rather than upright. We investigated its usability and possible limitations in its use for the treatment of pusher patients in two samples of healthy participants with an average age of 26.4 years and 63.9 years respectively. Individuals from both age groups showed similar levels of tolerance to prolonged exposure to the tilted visual environment for an average of 40.4 minutes while walking around in the hospital. The TRD was found to be comfortable and not frustrating whilst wearing, but somewhat challenging in terms of technical handling, particularly for older participants. At the end of the maximally tolerated exposure time participants of both groups experienced some feelings of discomfort, like dizziness or increased stomach awareness, which disappeared rapidly after terminating TRD exposure. Our TRD appears to be a practical device especially for an older population, like pusher patients. While users must be aware of the possibility of side effects, these should be balanced against the benefits of future use for rehabilitation purposes.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139558887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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