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Patient-Reported Outcome of a Multidisciplinary Pain Management Program, Focusing on Occupational Performance and Satisfaction with Performance 多学科疼痛管理项目的患者报告结果,关注职业表现和对表现的满意度
Pub Date : 2011-11-21 DOI: 10.2174/1874943701104010042
K. Samuelsson, U. Carlberg, Malin Hesselstrand, Elisabet Olander, E. Wressle
Aim: The aim was to describe the effect of a multidisciplinary pain management program, in terms of patientreported occupational performance and satisfaction with performance.Methods: The study is a retrospective, case series study. Data from interviews documented routinely in patient medical records were used. Interviews were made at introduction, on conclusion and six months after a pain management program. Data from all participants (n=85) introduced during one year, were analysed. The Canadian Occupational Performance Measure (COPM) was used as the main outcome measure.Results: Estimated occupational performance as well as satisfaction with performance improved between measures (occupational performance p<0.001; satisfaction with performance p<0.001). The percentage of participants, who improved two or more points on the COPM ten-point scale between baseline and the 6-month follow up, was 27% for occupational performance and 40% for satisfaction with performance.Conclusion: The findings raise questions regarding what the team might learn from different ways of scrutinizing results; the relevant level of MID in this program; and the overall objective in terms of the proportion of clients who reported a ‘successful’ outcome in occupational performance and satisfaction with performance, based on the identified MID. These questions need to be further analysed and discussed within the professional team.
目的:目的是描述多学科疼痛管理方案的效果,根据患者报告的职业表现和对表现的满意度。方法:采用回顾性、病例系列研究。病人医疗记录中例行记录的访谈数据被使用。访谈分别在疼痛管理项目开始时、结束时和六个月后进行。对一年内引入的所有参与者(n=85)的数据进行分析。加拿大职业绩效测量(COPM)被用作主要的结果测量。结果:评估职业绩效和对绩效的满意度在测量之间有所改善(职业绩效p<0.001;绩效满意度p<0.001)。在基线和6个月的随访期间,在COPM 10分制上提高2分或2分以上的参与者的百分比在职业表现方面为27%,在工作满意度方面为40%。结论:这些发现提出了一个问题,即团队可以从不同的审查结果的方式中学到什么;本项目相关的MID水平;以及总体目标,即根据已确定的MID,报告在职业表现和表现满意度方面取得“成功”结果的客户比例。这些问题需要在专业团队中进一步分析和讨论。
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引用次数: 7
Impaired Muscle Oxygenation During Incremental Cycle Exercise in COPD Patients Compared with Age-Matched Healthy Subjects 与年龄匹配的健康受试者相比,COPD患者在增量循环运动中肌肉氧合受损
Pub Date : 2011-11-02 DOI: 10.2174/1874943701104010032
Yoshitaka Tateishi, Y. Eguchi, Yoshiki Tohyama, K. Hirata, S. Fujimoto
This study examined the dynamics of muscle oxygenation during exercise between chronic obstructive pulmonary disease (COPD) patients and age-matched healthy controls. Oxygen saturation of the vastus lateralis muscle (SmO2) was measured during incremental cycle exercise in 11 patients with exercise intolerance below the anaerobic threshold (AT) workload (COPD-AT(-)), 11 patients with exercise intolerance above the AT workload (COPD-AT(+)), and 8 controls by using near-infrared spectroscopy. Despite lower peak workload in COPD patients than in controls, trough SmO2 in COPD-AT(-) patients was significantly lower than SmO2 at the AT workload in controls, and was the same level as trough SmO2 in COPD-AT(+) patients and trough SmO2 in controls. The decrease of SmO2 was correlated with forced expiratory volume in one second % in COPD-AT(+) patients, and with exercise-induced hypoxemia in COPD-AT(-) patients. In conclusion, muscle oxygenation status deteriorates more steeply during exercise in COPD patients than in age-matched controls. Such severe impairment of muscle oxygenation in COPD patients may be affected by the impairment of lung function caused by COPD.
本研究检测了慢性阻塞性肺疾病(COPD)患者和年龄匹配的健康对照者在运动过程中的肌肉氧合动力学。采用近红外光谱法测量了11例无氧阈值(AT)负荷以下的运动不耐受患者(COPD-AT(-))、11例AT负荷以上的运动不耐受患者(COPD-AT(+))和8例对照者在增量循环运动期间的股外侧肌氧饱和度(SmO2)。尽管COPD患者的峰值工作负荷低于对照组,但COPD- at(-)患者的过SmO2水平显著低于对照组在at工作负荷下的SmO2水平,与COPD- at(+)患者和对照组的过SmO2水平相同。COPD-AT(+)组SmO2降低与1秒用力呼气量%相关,COPD-AT(-)组SmO2降低与运动所致低氧血症相关。总之,COPD患者在运动期间肌肉氧合状态比同龄对照组恶化得更快。COPD患者如此严重的肌肉氧合损害可能与COPD引起的肺功能损害有关。
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引用次数: 3
Questions Posed within Written Feedback in Clinical Education: A Research Note 在临床教育书面反馈中提出的问题:一份研究报告
Pub Date : 2011-10-26 DOI: 10.2174/1874943701104010028
Shannon Emmerson, Gina D. Tillard, T. Ormond, R. Ramsay, Brooke Moore
Clinical educators use a variety of methods to facilitate student development of critical thinking. One method is the use of effective questioning within written feedback. High level questions help to facilitate critical thinking by requiring the student to evaluate or make judgment on a clinical situation. As students progress through a continuum of competency from novice to graduate, the nature of feedback changes from directives to questions in response to the students' developing critical thinking abilities. This research notes details aspects in written feedback within a speech pathology educational setting. Novice students received lower level questions and more directives compared to advanced students. Suggestions for monitoring the ways in which questions are presented within written feedback are discussed.
临床教育工作者使用各种方法来促进学生批判性思维的发展。一种方法是在书面反馈中使用有效的提问。高水平的问题通过要求学生对临床情况进行评估或判断,有助于促进批判性思维。随着学生从新手到毕业生的连续能力的进步,反馈的性质从指示转变为问题,以回应学生发展的批判性思维能力。本研究记录了语言病理学教育背景下书面反馈的细节。与高级学生相比,初级学生收到的问题水平较低,指示更多。讨论了在书面反馈中监控问题提出方式的建议。
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引用次数: 5
Perceptions of the Clinical Competence of New Speech-Language Pathology Graduates in New Zealand: A Research Note 新西兰新言语语言病理学毕业生临床能力的感知:一项研究记录
Pub Date : 2011-07-15 DOI: 10.2174/1874943701104010023
Gina D. Tillard, K. Lawson, Shannon Emmerson
Background: This study arose as the Course Leader sought feedback on the adequacy of the programme to prepare new graduates for professional practice. Aims: The aim was to examine how well an undergraduate degree programme prepared speech pathology graduates for the workforce, focussing on a range of core competencies including theoretical knowledge, clinical skills and professionalism. Methods & Procedures: Thirty new graduates and 30 employers were approached to participate in the study, with 19 and 16 accepting respectively. A written survey of 15 questions, 11 of which employed a Likert 5-point scale, and four of which were open-ended requiring a short written answer. Of the 11 rateable questions, nine were directed at both graduates and employers and the remaining three were directed at either group. Results were subjected to non-parametric between group comparisons. Open-ended questions were scanned for themes. Outcomes and Results: Employers and graduates did not differ on their perception of new graduate competence across all skill areas except writing skills. The employers rated the new graduates significantly lower on writing skills than did graduates. Both employers and graduates believed they were well-prepared for professional practice. Emerging themes in the open-ended questions were the continuity of location of clinical placements and employment, professional development, professional support, integration of academic and clinical education, and specific topic areas of strengths and weaknesses in the undergraduate curriculum. Conclusions: The study provides insight as to the preparedness of new SLP graduates upon entering the workforce. Considering the views of both the new graduate and employer are vital if university programmes are to address the expanding scope of practice in the field of communication sciences and disorders.
背景:这项研究是在课程负责人就该课程是否足以为新毕业生的专业实践做准备征求反馈意见时产生的。目的:目的是考察本科学位课程如何为言语病理学毕业生做好就业准备,重点关注一系列核心能力,包括理论知识、临床技能和专业精神。方法与步骤:30名应届毕业生和30名雇主参与研究,分别有19名和16名接受调查。一份包含15个问题的书面调查,其中11个问题采用李克特5分制,其中4个是开放式的,需要简短的书面回答。在11个可评税的问题中,有9个问题是针对毕业生和雇主的,其余3个问题是针对任何一个群体的。结果采用组间非参数比较。扫描开放式问题的主题。结果和结果:雇主和毕业生对新毕业生在除写作技能外的所有技能领域的能力的看法没有差异。雇主对应届毕业生写作技巧的评价明显低于应届毕业生。雇主和毕业生都认为他们已经为专业实践做好了充分的准备。开放式问题中的新主题是临床实习和就业地点的连续性,专业发展,专业支持,学术和临床教育的整合,以及本科课程中优势和劣势的具体主题领域。结论:该研究提供了洞察力的准备新的SLP毕业生进入劳动力市场。如果大学课程要解决传播科学和疾病领域不断扩大的实践范围,考虑新毕业生和雇主的观点是至关重要的。
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引用次数: 6
Efficiency or Quality of Experience: A Laboratory Study of Three Eyes- Free Touchscreen Menu Browsing User Interfaces for Mobile Phones 效率还是体验质量:手机三眼无触摸屏菜单浏览用户界面的实验室研究
Pub Date : 2011-06-17 DOI: 10.2174/1874943701104010013
V. Kulyukin, W. Crandall, D. Coster
A growing number of individuals who are blind or visually impaired is using smartphones in their daily activities. The touchscreen is a standard component of smartphones. While benefitting people with low vision by enhancing control of the text style and color and the size of images and text, the touchscreen has the downside for visually impaired users in that physical buttons for input of command selection and text entry are replaced with the touchscreen's soft buttons. To overcome this limitation, we are investigating eyes-free approaches to using the smartphone's touchscreen for information browsing. In this article, we present a laboratory study of three eyes-free touchscreen user interfaces for browsing menu hierarchies. Our findings indicate that quality of experience and familiarity may be as important as the time efficiency of completing tasks.
越来越多的盲人或视障人士在日常活动中使用智能手机。触摸屏是智能手机的标准部件。虽然通过加强对文本样式和颜色以及图像和文本大小的控制使弱视人士受益,但对于视障用户来说,触摸屏也有缺点,即用于输入命令选择和文本输入的物理按钮被触摸屏的软按钮所取代。为了克服这一限制,我们正在研究一种不用眼睛就能使用智能手机触摸屏浏览信息的方法。在这篇文章中,我们提出了一个实验室研究的三个无眼触摸屏用户界面浏览菜单层次结构。我们的研究结果表明,经验的质量和熟悉程度可能与完成任务的时间效率一样重要。
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引用次数: 10
Modeling One-Switch Row-Column Scanning with Errors and Error Correction Methods 带误差的单开关行-列扫描建模及纠错方法
Pub Date : 2011-04-14 DOI: 10.2174/1874943701104010001
R. Simpson, R. Mankowski, H. Koester
Single switch scanning has lots of different configuration options. One way to choose the most appropriate configuration for a client is to use a model to predict performance under different configurations. Most existing models expect error-free performance, however, and none integrates all the types of errors that can occur and the variety of error- correction methods that are available. A model is presented which predicts user performance for single-switch row- column scanning with errors and error-correction methods. The model is used to draw conclusions about the utility of different error-correction methods.
单交换机扫描有很多不同的配置选项。为客户机选择最合适的配置的一种方法是使用模型来预测不同配置下的性能。然而,大多数现有模型都期望无错误的性能,并且没有一个集成了可能发生的所有类型的错误和可用的各种错误纠正方法。提出了带误差和纠错方法的单开关行-列扫描用户性能预测模型。利用该模型得出了不同误差校正方法的有效性结论。
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引用次数: 15
Dual Tasking Under Compromised Visual and Somatosensory Input in Elderly Fallers and Non-Fallers 老年跌倒者和非跌倒者在视觉和体感输入受损情况下的双重任务
Pub Date : 2010-12-10 DOI: 10.2174/1874943701003010169
J. Swanenburg, E. D. Bruin, S. Hegemann, D. Uebelhart, T. Mulder
Background: Performance of additional tasks disturbs postural control in elderly. It is unknown, however, how postural control is affected in elderly fallers and non-fallers in a reduced sensory situation. Objective: To compare differences between single and dual tasking in three test conditions; (1) no-vision, (2) under reduced somatosensory information and (3) with a combination of both conditions. Design: An observational cohort study with participants assigned to a 12-month pretest fall assessment and a postural balance assessment. Methods: Fifteen independently living elderly participated (77.5 ± 7.0 [63-87] years). Falls were pre-assessed with a 1- year monthy “fall calendar”. Postural control was analyzed by means of a force platform. Participants were standing quiet (first task) while counting backwards (second task). A 2-factor (group x condition) ANOVA was performed at p<.05. Differences of postural (DTCp) and cognitive dual task costs (DTCc) between test conditions were analyzed (one-way ANOVA). Results: The analysis showed significant group (fallers/non-fallers) and condition effects. Post hoc analyses indicated that the postural control variables were significantly different during the concurrent reduced vision and somatosensory information. Dual task costs showed a significant difference between normal (N) and the combined condition (NV+RP) in non-fallers. Conclusion: The combination of reduced visual and somatosensory information causes a larger disturbance of postural stability compared with the reduction of visual or somatosensory information alone. Non-fallers seem to have no threats to the postural control stability in this combined reduced sensory situation. They reduce their postural control, which leaves them enough resources to compensate for the reduced sensory information.
背景:附加任务的执行会干扰老年人的姿势控制。然而,目前尚不清楚的是,在老年跌倒者和非跌倒者的感觉能力下降的情况下,姿势控制是如何受到影响的。目的:比较三种测试条件下单任务与双任务的差异;(1)无视力;(2)体感信息减少;(3)两种情况的结合。设计:一项观察性队列研究,参与者被分配到12个月的测试前跌倒评估和姿势平衡评估。方法:15名独立生活老年人(77.5±7.0[63-87]岁)参与。用1年一个月的“秋季日历”预先评估跌倒情况。利用力平台对姿态控制进行了分析。参与者安静地站着(第一项任务),同时倒数(第二项任务)。双因素(x组)方差分析,p< 0.05。采用单因素方差分析(one-way ANOVA)分析不同测试条件下姿势双任务成本(DTCp)和认知双任务成本(DTCc)的差异。结果:分析显示各组(跌倒者/非跌倒者)及病情效果显著。事后分析表明,在视觉和体感信息同时降低的情况下,体位控制变量存在显著差异。双任务成本在正常(N)和联合条件(NV+RP)之间有显著差异。结论:视觉和体感信息联合减少比单独减少视觉或体感信息对体位稳定性造成更大的干扰。在这种综合感官减少的情况下,不摔倒的人似乎对姿势控制的稳定性没有威胁。他们减少了对姿势的控制,这给他们留下了足够的资源来补偿减少的感觉信息。
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引用次数: 8
Electrode Placement in Surface Electromyography (sEMG) ”Minimal Crosstalk Area“ (MCA) 表面肌电图(sEMG)“最小串扰区”(MCA)中的电极放置
Pub Date : 2010-11-05 DOI: 10.2174/1874943701003010110
Y. Blanc, U. Dimanico
This paper is an introduction to a workshop on electrodes location and specific exercises. Selectivity of EMG electrodes depends on their interspacing, their conductive area and axis direction with respect to the direction of the underlying muscular fibres. Minimal cross talk area (MCA) helps to limit or avoid crosstalk from neighbouring muscles. We present examples of MCA and typical sEMG patterns during specific exercises.
这篇论文介绍了一个关于电极位置和具体练习的研讨会。肌电图电极的选择性取决于它们的间距、导电面积和相对于底层肌肉纤维方向的轴向。最小相声面积(MCA)有助于限制或避免来自邻近肌肉的相声。在具体的练习中,我们给出了MCA和典型的肌电图的例子。
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引用次数: 69
History of the Study of Skeletal Muscle Function with Emphasis on Kinesiological Electromyography 骨骼肌功能研究的历史,重点是运动学肌电图
Pub Date : 2010-11-05 DOI: 10.2174/1874943701003010084
Y. Blanc, U. Dimanico
Study of muscles started probably when someone tried to understand how he can move from A to B and executes movements at will. Knowledge was always dependent on the technology available to conduct investigation. Religious belief had a negative impact on muscle study when interfering with dissection of human corpse. During the Italian Renaissance (end of XIV th to beginning of XVI th century), study of muscles was first descriptive, based on dissection. Artists like Leonardo da Vinci (1452-1519) and Michael Angelo (1475-1564) exaggerated the bulk of muscles. Their first concern was the influence of the volume of the superficial muscle on the surface modelling represented in their paintings and sculptures. Leonardo da Vinci multiplied the number of bundles of some muscles. Most of his representations of tendon insertions are imprecise. Leonardo da Vinci applied mechanical principles to rib, elbow kinematics and kinetics of the foot. Vesalius (1514-1574) was a medical doctor and an anatomist. His anatomical plates are remarkable because they respect most of the relationships between muscles. Then Galileo (1564-1642), Borelli (1608- 1679) and Newton (1642-1727) thought that physics and mechanical laws governed motility of animal and human body alike. Incidental discovery of electro stimulation effect on muscle in Galvani's laboratory and electric current concomitant of muscles contraction by Matteucci and Du Bois Reymond were major breakthroughs. Recording of this current was the starting point for ECG, EMG and EEG. ECG entered first in the clinic. EMG and EEG waited for cathode ray oscilloscope. The Voltaic Pile and faradic current opened the door of electrical stimulation to Duchenne de Boulogne (1806-1875). Matteucci's (1811-1868) publications inspired and stimulated Du Bois Reymond. Du Bois Reymond (1818-1889) repeated and completed his experiments on frogs. He designed a very sensitive galvanometer with which he recorded his own global EMG. EMG remained a curiosity of laboratory until Erlander (1874- 1965) and his pupil Gasser (1888-1963) improved the cathode ray oscilloscope for electrophysiological recordings. A combination of orthopaedic surgeons, engineers and physiologists in Berkeley (1945) systematically recorded EMG during gait of normal man. EMG biofeedback and phonomyography have also raised interest by clinicians. Their EMG signals processing in the time domain (full wave rectification miscalled integrated EMG) was later completed in the early '80s by computation of the root mean square on personal computers. Despite all factors minimizing the reliability of analysis based on amplitude of the EMG signals, these methods still represent the clinician's routine tool today. Since 1999, researchers have proven the benefits of muscular intensity analysis, time frequency analysis, mapping of spatio temporal activity. We deplore that the corresponding software is not available for clinicians. Multivariate methods of statistics allow the compa
对肌肉的研究可能始于有人试图理解他如何从A点移动到B点,并随心所欲地执行动作。知识总是依赖于现有的进行调查的技术。宗教信仰干扰人体解剖时,对肌肉研究有负面影响。在意大利文艺复兴时期(十四世纪末至十六世纪初),对肌肉的研究首先是描述性的,基于解剖。像达芬奇(1452-1519)和米开朗基罗(1475-1564)这样的艺术家夸大了肌肉的体积。他们首先关注的是表面肌肉的体积对他们绘画和雕塑中所表现的表面造型的影响。列奥纳多·达·芬奇把一些肌肉束的数量增加了一倍。他对肌腱插入的描述大多是不精确的。列奥纳多·达·芬奇将机械原理应用于肋骨、肘部的运动学和足部的动力学。维萨里(1514-1574)是一位医生和解剖学家。他的解剖板是非凡的,因为它们尊重了肌肉之间的大部分关系。然后,伽利略(1564-1642)、博雷利(1608- 1679)和牛顿(1642-1727)认为,物理和机械定律支配着动物和人体的运动。伽伐尼实验室偶然发现的肌肉电刺激效应和Matteucci和Du Bois Reymond偶然发现的肌肉收缩伴随电流是重大突破。该电流的记录是心电图、肌电图和脑电图的起点。首先进入诊所的是心电图。肌电和脑电图等待阴极射线示波器。伏打电堆和法拉第电流为布洛涅(1806-1875)打开了电刺激的大门。马特乌奇(1811-1868)的著作启发和激励了杜波依斯·雷蒙。杜波依斯·雷蒙(1818-1889)重复并完成了他对青蛙的实验。他设计了一个非常灵敏的振镜,用它来记录他自己的全球肌电图。在Erlander(1874- 1965)和他的学生Gasser(1888-1963)改进了用于电生理记录的阴极射线示波器之前,肌电图一直是实验室的好奇心。伯克利的骨科医生、工程师和生理学家(1945)系统地记录了正常人走路时的肌电图。肌电图生物反馈和声像术也引起了临床医生的兴趣。他们的肌电信号时域处理(全波整流,误称集成肌电信号)后来在80年代初在个人电脑上通过计算均方根完成。尽管所有因素都降低了基于肌电图信号振幅分析的可靠性,但这些方法仍然是当今临床医生的常规工具。自1999年以来,研究人员已经证明了肌肉强度分析、时频分析、时空活动映射的好处。我们遗憾的是,没有相应的软件可供临床医生使用。多元统计方法可以比较病理状态下的肌电图,有助于鉴别诊断。
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引用次数: 8
Principal Component Analysis of Electromyographic Signals: An Overview 肌电信号的主成分分析综述
Pub Date : 2010-11-05 DOI: 10.2174/1874943701003010127
G. Bosco
Surface electromyography (EMG) is a widely used, straight-forward, technique which allows to investigate patterns of neuromuscular activation. In contrast to the relative simplicity of the recording technique, the analysis of the derived electric signals may be rather sophisticated. The last decade, in particular, has been characterized by the development of a several quantitative approaches to the analysis of the EMG signals. The common principle underlying these analyses is the decomposition of the EMG signal waveforms in a small set of basis waveforms that capture most of the relevant features of the source EMGs and define a low-dimensional space on which the original EMG activation patterns can be represented as vectors. This could be particularly useful when the aim is to classify quantitatively EMG patterns recorded across muscles or from the same muscle across several motor tasks. Within this framework, this article will be focused on one of these approaches, the Principal Component Analysis, which has a strong potential for large scale diffusion both in research and clinical settings because of its conceptual simplicity and high practicality. The intent is to provide an overview/tutorial of the PCA applied to surface EMG signals, first by outlining the main methodological aspects and, then, by drawing examples from the movement control literature where PCA has been used effectively to gain insight on the neural processes that may underlie the control of common actions of our motor repertoire such as arm pointing and gait.
表面肌电图(EMG)是一种广泛使用的、直接的技术,它允许研究神经肌肉激活的模式。与相对简单的记录技术相比,对衍生电信号的分析可能相当复杂。特别是在过去的十年里,已经发展了几种定量方法来分析肌电图信号。这些分析背后的共同原则是将肌电信号波形分解为一小组基本波形,这些基本波形捕获了源肌电信号的大部分相关特征,并定义了一个低维空间,在这个空间上,原始肌电信号激活模式可以被表示为向量。当目的是对跨肌肉记录的肌电图模式进行定量分类或从同一肌肉在几个运动任务中记录的肌电图模式时,这可能特别有用。在此框架内,本文将重点关注其中一种方法,即主成分分析,由于其概念简单和高度实用性,在研究和临床环境中具有大规模推广的强大潜力。本文的目的是提供一个PCA应用于表面肌电信号的概述/教程,首先概述了主要的方法方面,然后从运动控制文献中提取例子,在这些文献中,PCA被有效地用于深入了解神经过程,这些神经过程可能是控制我们的运动技能(如手臂指向和步态)的基础。
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引用次数: 25
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The open rehabilitation journal
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