scholarly journals Daily activity in minimal footwear increases foot strength

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rory Curtis ◽  
Catherine Willems ◽  
Paolo Paoletti ◽  
Kristiaan D’Août

AbstractThe human foot is uniquely adapted to bipedal locomotion and has a deformable arch of variable stiffness. Intrinsic foot muscles regulate arch deformation, making them important for foot function. In this study we explore the hypothesis that normal daily activity in minimal footwear, which provides little or no support, increases foot muscle strength. Western adults wore minimal footwear for a six-month period (the “intervention” group). Foot strength, i.e., maximum isometric plantarflexion strength at the metatarsophalangeal joints, and foot biometrics were measured before and after the intervention. An additional group was investigated to add further insight on the long-term effects of footwear, consisting of Western adults with an average 2.5 years of experience in minimal footwear (the “experienced” group). This study shows that foot strength increases by, on average, 57.4% (p < 0.001) after six months of daily activity in minimal footwear. The experienced group had similar foot strength as the post intervention group, suggesting that six months of regular minimal footwear use is sufficient to gain full strength, which may aid healthy balance and gait.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p&lt; 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures


Author(s):  
Cecilia Ruiz-Esteban ◽  
Jaime Terry Andrés ◽  
Inmaculada Méndez ◽  
Ángela Morales

This study aimed to investigate the influence of a structured movement activity program on the motor development of children aged three to five years attending preschool. Participants were 136 preschool students with normative development at three to four years old who lived in the Region of Murcia (Spain). The McCarthy Children’s Psychomotricity and Aptitude Scales (MSCA) battery of psychomotor tests was used to evaluate the motor development profiles of preschoolers before and after the intervention. The sample was divided into two groups: an intervention group (28 students) and a comparison group (108 students). A structured 24 week physical education program was used in the intervention group. An experiential program based on free play was used in the comparison group during the same period. Preschoolers in both groups got a significant improvement in the contrast of pre-intervention with post-intervention in limb coordination. Statistically significant differences in the post-intervention measurements between the comparison group and the intervention group on arm and leg coordination were observed, whereby the intervention group presented higher arm coordination values (F1,134 = 14,389, p = 0.000, η2 = 0.097) and higher leg coordination values (F1,134 = 19,281, p = 0.000, η2 = 0.126) than the comparison group. It was pointed out that structured physical activity education is better educational methodology than free play to achieve adequate motor development in preschool children.


2020 ◽  
Vol 40 (02) ◽  
pp. 99-107
Author(s):  
Jin-Oh Ahn ◽  
Jong-Hyuck Weon ◽  
Eun-Kyung Koh ◽  
Do-Young Jung

Background: Stretching and length test of hamstring muscles have been performed commonly to manage lower back pain (LBP) in sports rehabilitation. Previous literatures addressed that stretching techniques and length test of hamstring muscles should be performed with the pelvic maintained in an anterior tilt position. However, there is no study to determine the effectiveness of pressure biofeedback unit (PBU) to maintain in anterior pelvic tilting (APT) on length test and stretching of hamstring muscles. Objective: To determine the effectiveness of hamstring muscles stretching using a PBU. Methods: Forty participants with shortness of hamstrings randomized into two groups. Participants performed the active knee extension (AKE) stretching without (control group) or with PBU (intervention group) for four weeks. AKE tests without and with PBU were administered three times before and after hamstrings stretching by each group. Results: The AKE test without PBU showed a significant main effect of time ([Formula: see text]) but not of group ([Formula: see text]) on the AKE angle. The AKE test with PBU showed a significant increase in the AKE angle in the post-intervention compared to the pre-intervention assessments in both groups ([Formula: see text]). The difference of AKE angle between the pre- and post-intervention results was significantly greater in the intervention group than in the control group ([Formula: see text]). Conclusion: We recommend the use of a PBU to maintain the pelvic anterior tilting position when performing the AKE test or AKE stretching.


2020 ◽  
Vol 37 (4) ◽  
pp. 369-380
Author(s):  
Akbar Sarvari ◽  
Hosein Habibzadeh ◽  
Leyla Alilu ◽  
Naser Sheikhi

The waiting time for patients in the emergency department to receive health services influences many processes in this department. This research aimed to determine the effect of implementation and deployment of emergency severity index (ESI) on the waiting time for patients to receive health services in the emergency department. This quasi-experimental study was performed on 736 patients who were referred to the emergency department of Imam Khomeini Hospital of Mahabad. For the ESI triage implementation, 368 patients were assigned to the pre-intervention group and 368 patients were selected for the post-intervention group, using a simple random sampling. Before and after the ESI triage implementation, the waiting time for patients to receive services was measured and recorded using a chronometer. For data analysis, Chi-square, Mann-Whitney and Kruskal-Wallis tests were used. Before and after the intervention, both groups were homogeneous in terms of demographic variables (p > 0.05). The results of Mann-Whitney test indicate that implementation of emergency severity index (ESI) has a positive effect on the decrease of average time intervals to provide health services, as well as on the entire length of stay in the emergency department (p < 0.05). Given the effect of the ESI triage implementation that reduced the waiting time for patients to receive health services, ESI is recommended for training nurses and other emergency staff.


2021 ◽  
Author(s):  
Hung-Yuan Su ◽  
Jen-Long Tsai ◽  
Yin-Chou Hsu ◽  
Kuo-Hsin Lee ◽  
Chao-Sheng Chang ◽  
...  

Abstract Timely performing electrocardiography (ECG) is crucial for early detection of ST-elevation myocardial infarction (STEMI). For shortening door-to-ECG time, a chief complaint-based “cardiac triage” protocol comprising (1) raising alert among medical staff with bedside triage tags, and (2) immediate bedside ECG after focused history-taking was implemented at the emergency department (ED) in a single tertiary referral center. All patients diagnosed with STEMI visiting the ED between November 2017 and January 2020 were retrospectively reviewed to investigate the effectiveness of strategy before and after implantation. Analysis of a total of 117 ED patients with STEMI (pre-intervention group, n = 57; post-intervention group, n = 60) showed significant overall improvements in median door-to-ECG time from 5 to 4 minutes (p = 0.02), achievement rate of door-to-ECG time < 10 minutes from 45–57% (p = 0.01), median door-to-balloon time from 81 to 70 minutes (p < 0.01). Significant trends of increase in achievement rates for door-to-ECG and door-to-balloon times (p = 0.01 and p = 0.006, respectively) was noticed after strategy implementation. The incidence of door-to-ECG time > 10 minutes for those with initially underestimated disease severity was also reduced from 90–10% (p < 0.01). In conclusion, a chief complaint-based “cardiac triage” strategy successfully improved the quality of emergency care for STEMI patients through reducing delays in diagnosis and treatment.


2021 ◽  
pp. 1-9
Author(s):  
Karin Egberg Thyme ◽  
Björn Tavelin ◽  
Inger Öster ◽  
Jack Lindh ◽  
Britt Wiberg

Abstract Objective This follow-up study on perceived self-image and psychophysical distress/psychic symptoms was based on a ranomized contolled study of art therapy on women with breast cancer. Method The aim was to examine the long-term effects of time-limited art therapy using the instruments of Structural Analysis of Social Behavior (SASB) and Symptom Check List-90 (SCL-90). Results Three attachment clusters of the SASB showed significant changes post therapy: Autonomous self (cluster 1), Accepting self (cluster 2), and Loving self (cluster 3). Clusters 2 and 3 continued to change in favor of the intervention group at the 5-year follow-up. There were no significant differences in the SCL-90 results between the intervention group and the control group in the follow-up study. Significance of results The art therapy intervention was both therapeutic and psycho-educative. The conclusion of this study is that approaching emotions through time-limited art therapy seems to have a long-lasting effect on the attachment behavioral system shown in the SASB model post intervention, and this effect remained 5 years later.


2019 ◽  
Vol 13 (3) ◽  
pp. 1-12 ◽  
Author(s):  
Eva Nissen ◽  
Kristin Svensson ◽  
Scovia Mbalinda ◽  
Kajsa Brimdyr ◽  
Peter Waiswa ◽  
...  

Background Uninterrupted skin-to-skin contact between mothers and newborns during the first hour after birth has been reported to be 2% in Uganda. Aims To investigate if a low-cost intervention targeting the behaviors of hospital staff would increase skin-to-skin contact and to investigate whether skin-to-skin contact stabilised temperature in the newborn. Methods The study had a quasi-experimental, before and after design. The sample included 110 in the pre-intervention group, and 93 in the post-intervention group. Data collection included observations of skin-to-skin contact and temperature measurements. Data were also collected from medical records and interviews. Findings No infants had skin-to-skin contact before the intervention, whereas the proportion was 54.8% after the intervention. Infants who received skin-to-skin contact (n=51) and infants who did not receive skin-to-skin contact (n=146) increased in temperature; however, infants who received skin-to-skin contact were significantly warmer after 5 minutes and remained so at 60 minutes. Conclusions The intervention increased the practice of skin-to-skin contact, which was found to be safe in regard to temperature stabilisation.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S46-S46
Author(s):  
Anna Witt ◽  
Mason G Harper ◽  
Juan Carlos Rico Crescencio ◽  
Ryan K Dare ◽  
Mary Burgess

Abstract Background An antimicrobial stewardship program (ASP) strategy to minimize the use of overly broad antimicrobials is to suppress specific antimicrobial susceptibility results when isolates are sensitive to narrow antibiotics. There is limited data on possible adverse outcomes of this method. Patients with febrile neutropenia (FN) and gram-negative bacteremia (GNB) whose culture is sensitive to non-pseudomonal antibiotics still require broader pseudomonal coverage to treat the syndrome of FN. We evaluated if ASP suppression of anti-pseudomonal antibiotics adversely affects patients with FN and GNB. Methods In February 2018, our institution’s ASP began suppressing cefepime and meropenem susceptibility results from E. coli, Klebsiella spp, and Proteus spp when sensitive to cefepime (MIC ≤ 2), ceftriaxone and ceftazidime. We performed a retrospective analysis of patients with FN and GNB from 2016 – 2020 to evaluate the appropriateness of antibiotic regimens before and after the ASP intervention. Antibiotic regimens were deemed inappropriate if the patient was de-escalated to a narrow-spectrum, non-pseudomonal agent while neutropenic. Of 338 inpatient encounters identified with any bacteremia and FN, 49 were due to non-Pseudomonas, non-ESBL GNB, 20 before and 29 after the intervention. Sixteen of the 29 post-intervention patients were excluded, as their isolates did not meet suppression criteria. This resulted in a total of 13 patients in the post-intervention group. Results After culture susceptibility reports were released, 3 out of 20 patients in the pre-intervention group (15%) and 4 out of 13 patients in the post-intervention group (30.8%) were inappropriately tailored to narrow-spectrum antibiotics (p=0.39). There was no significant difference in 30-day mortality, 10.0% pre- and 0% post-intervention (p=0.50), or amount of meropenem prescribed, 45% pre- and 38.5% post-intervention (p=0.74). Conclusion These data show no significant difference in inappropriate antibiotic regimens prescribed for patients with FN and GNB after ASP antibiotic suppression was implemented. 30-day mortality was also not affected. The ASP intervention did not decrease meropenem prescriptions in this patient group, which may be appropriate. Larger studies are needed to verify these findings. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support) Mary Burgess, MD, Pfizer Inc (Grant/Research Support)


2021 ◽  
Vol 19 (1) ◽  
pp. 1-6
Author(s):  
Maria Clara Soares de Oliveira Vaz ◽  
Wagner De Campos ◽  
Marcio José Kerkoski ◽  
Gilmar Afonso

OBJETIVO: O objetivo do trabalho foi analisar os efeitos de um novo programa de intervenção na coordenação motora grossa (CMG) de crianças entre os 05 e 10 anos, avaliadas pela bateria de testes KTK. MÉTODOS: O programa foi realizado em 73 estudantes, selecionados de maneira não probabilística objetiva, com idades entre 05 e 10 anos, de uma rede municipal de ensino da cidade de Curitiba/PR, Brasil, divididos em dois grupos: Grupo Controle (GC=35) e Grupo Intervenção (GI=38). A CMG foi avaliada antes e depois da intervenção por meio da bateria de testes KTK. O programa de intervenção consistiu em 12 semanas de atividades alicerçadas nas estruturas da Técnica de Motivação Orientada Para Maestria (TARGET), e no livro “Escola da Bola – Um ABC para Iniciantes nos Jogos Esportivos”. Os efeitos foram testados utilizando o Teste de Cohen e teste t (dependente e independente).RESULTADOS: Na testagem t dependente, diferenças estatisticamente significativas foram encontradas no GI, do primeiro para o segundo momento, em todos os testes (d≥0,80). O GI obteve uma melhora significativa ao longo das 12 semanas (p0,05), enquanto no GC não houve diferenças estatisticamente significativas. Na testagem t independente, no momento pré-intervenção (1º Momento), foram encontradas diferenças significativas (p0,05) nas quatro tarefas, favoravelmente ao GC. No momento pós-intervenção, diferenças estatisticamente expressivas não foram observadas entre o GI e GC. CONCLUSÃO: Conclui-se que um programa interventivo, com duração de 12 semanas, utilizando os jogos da “Escola da Bola” em conjunto com o “TARGET”, trazem melhorias significativas no desempenho coordenativo das crianças, entre 5 e 10 anos de idade.Analyses of the effects of an intervention program based on TARGET structure and “Escola da Bola” on the gross motor coordinationABSTRACT OBJECTIVE: The objectives of the work were to analyze the effects of a new intervention program on gross motor coordination (GMC) of 5 and 10 year old children, diagnosed by the KTK battery test. METHODS: The program was carried out in 73 students, selected in an objective non-probabilistic way, aged between 5 and 10 years, from a municipal education network in the city of Curitiba, Brazil, divided into two groups: Control Group (CG=35) and Intervention Group (IG=38). CMG was assessed before and after the intervention using the KTK test battery. The intervention program consisted in 12 weeks of activities based on the structures of the Mastery-Oriented Motivation Technique (TARGET), and the book “Escola da Bola – Um ABC para Iniciantes nos Jogos Esportivos”. The effects were tested using the Cohen test and t-test (dependent and independent). RESULTS: In the dependent t-test, statistically significant differences were found on the IG, from the first to the second moment, in all tests (d≥0.80). The IG achieved a significant improvement over the 12 weeks (p0,05), while in the CG there were no statistically significant differences. In the independent t-test, in the pre-intervention moment (1st Moment), significant differences (p0,05) were found on the four tasks, in favor of the CG. In the post-intervention moment, statistically significant differences were not observed between the IG and CG. CONCLUSION: It follows that an intervention program, lasting 12 weeks, using the games of “Escola da Bola” together with “TARGET”, brings significant improvements in children’s coordinative performance, between 5 and 10 years old.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038871
Author(s):  
Anteneh Asefa ◽  
Alison Morgan ◽  
Samson Gebremedhin ◽  
Ephrem Tekle ◽  
Sintayehu Abebe ◽  
...  

ObjectivesThere is a lack of evidence on approaches to mitigating mistreatment during facility-based childbirth. This study compares the experiences of mistreatment reported by childbearing women before and after implementation of a respectful maternity care intervention.DesignA pre–post study design was undertaken to quantify changes in women’s experiences of mistreatment during facility-based childbirth before and after the respectful maternity care intervention.InterventionA respectful maternity care intervention was implemented in three hospitals in southern Ethiopia between December 2017 and September 2018 and it included training of service providers, placement of wall posters in labour rooms and post-training supportive visits for quality improvement.Outcome measuresA 25-item questionnaire asking women about mistreatment experiences was administered to 388 women (198 in the pre-intervention, 190 in the post-intervention). The outcome variable was the number of mistreatment components experienced by women, expressed as a score out of 25. Multilevel mixed-effects Poisson modelling was used to assess the change in mistreatment score from pre-intervention to post-intervention periods.ResultsThe number of mistreatment components experienced by women was reduced by 18% when the post-intervention group was compared with the pre-intervention group (adjusted regression coefficient (Aβ)=0.82, 95% CI 0.74 to 0.91). Women who had a complication during pregnancy (Aβ=1.17, 95% CI 1.01 to 1.34) and childbirth (Aβ=1.16, 95% CI 1.03 to 1.32) experienced a greater number of mistreatment components. On the other hand, women who gave birth by caesarean birth after trial of vaginal birth (Aβ=0.76, 95% CI 0.63 to 0.92) and caesarean birth without trial of vaginal birth (Aβ=0.68, 95% CI 0.47 to 0.98) experienced a lesser number of mistreatment components compared with those who had vaginal birth.ConclusionsWomen reported significantly fewer mistreatment experiences during childbirth following implementation of the intervention. Given the variety of factors that lead to mistreatment in health facilities, interventions designed to mitigate mistreatment need to involve structural changes.


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