Examination of a Clinical method of Assessing Postural Control during a Functional Performance Task

1999 ◽  
Vol 8 (3) ◽  
pp. 171-183 ◽  
Author(s):  
Bryan L. Riemann ◽  
Nancy A. Caggiano ◽  
Scott M. Lephart
Keyword(s):  
Postural Control ◽  
Repeated Measures ◽  
Functional Performance ◽  
Performance Tests ◽  
Performance Task ◽  
Clinical Method ◽  
Significant Relationships ◽  
Group 2 ◽  
And Performance ◽  
Group 1

Postural control and functional performance tests are often used separately during orthopedic postinjury assessments. The purpose of this investigation was to examine a clinical method of assessing postural control during a functional performance task. Thirty participants were divided into two groups. The first group was tested three times, the second group only once. The same tester evaluated each participant's performance during all testing sessions, and during the first two testing sessions (Group 1) two additional testers evaluated each performance. Intraclass correlational coefficients between the three testers ranged from .70 to .92. Session 1 (Group 1) scores were pooled with Group 2 scores, and correlational analyses were conducted between participant height and performance; no significant relationships were revealed. The scores from Group 1 were analyzed using between-days repeated-measures ANOVAs. Results revealed significant improvement between Sessions 1 and 3 for the static portion of the test. The results suggest that the multiple single-leg hop-stabilization test offers a method of assessing postural control during a functional performance task.

Effect of Knowledge of Directional Mistunings on the Tuning Accuracy of Beginning and Intermediate Wind Players

1995 ◽  
Vol 43 (3) ◽  
pp. 232-241 ◽  
Author(s):  
Cornelia Yarbrough ◽  
Brant Karrick ◽  
Steven J. Morrison
Keyword(s):  
Performance Tuning ◽  
First Year ◽  
Performance Task ◽  
Treatment Groups ◽  
Instrument Type ◽  
Group 3 ◽  
Group 2 ◽  
Wind Players ◽  
And Performance ◽  
Group 1

The purpose of this research was to study the effect of knowledge of directional mis-tunings on the tuning accuracy of beginning and intermediate wind players. Subjects (N = 197) were instrumental wind players who tuned to either an For a B-flat with both their own instrument—a performance task—and the tuning knob of a variable-pitch keyboard—a perception task. The subjects were randomly assigned to one of three treatment groups: Group 1 knew that their instruments and the tuning knob were mis-tuned in the sharp direction; Group 2 knew that their instruments and the tuning knob were mistuned in the flat direction; and Group 3 had no information regarding direction of mistunings. Data demonstrated that only years of instruction significantly affected subjects' tuning accuracy. There were no significant differences due to treatment, instrument type, or tuning pitch. There were only 6 in-tune performance responses and 12 in-tune perception responses. Approaching the target pitch from above resulted in more sharp responses; approaching it from below resulted in more flat responses; and having no knowledge of direction of mistuning resulted in an equal number of sharp and flat responses. There were a greater number of flat responses in the first year of instruction and a greater number of sharp responses in the fourth year. Finally, there was consistent improvement from the first to the fourth year in both perception and performance tuning tasks.

Predialytic versus Intradialytic Nutrition: A Study to Assess Effects on Intradialytic Blood Pressure, Dialysis Adequacy, and Urea Removal

2021 ◽  
pp. 1-6
Author(s):  
Namrata S. Rao ◽  
Abhilash Chandra ◽  
Sai Saran ◽  
Manish Raj Kulshreshta ◽  
Prabhakar Mishra ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Dialysis Adequacy ◽  
Fasting Period ◽  
Significant Group ◽  
Protein Requirements ◽  
Dialysis Vintage ◽  
Oral Nutritional Supplements ◽  
Blood Pressures ◽  
Group 2 ◽  
Group 1

<b><i>Background:</i></b> Provision of oral protein in hemodialysis (HD) is desirable due to improved compliance to protein requirements and better nutritional status, but the risks of hypotension and underdialysis need to be considered. This study compared 2 different timings for administering oral nutritional supplements (ONS), predialysis and mid-dialysis, with respect to hemodynamics, dialysis adequacy, urea removal, and tolerability. <b><i>Methods:</i></b> This single-center, prospective crossover study analyzed 72 stable patients with ESRD on twice a week maintenance HD with a mean age of 38.7 (±11.2) years and a dialysis vintage of 28.2 (±13.1) months. In the first week, all the patients received ONS (450 kcal energy, 20 g protein) 1 h prior to start of dialysis (group 1) and in the next week, the supplement was administered after 2 h of start of dialysis (group 2), with a predialysis fasting period of at least 3 h in both groups. Blood pressures, serum, and spent dialysate samples were collected and nausea occurrence was noted by severity. <b><i>Results:</i></b> Predialytic intake (group 1) was associated with higher predialysis and 1st hour blood urea, dialysis adequacy, and urea removal than group 2. Both groups achieved mean Kt/V &#x3e; 1.2, and the occurrence of symptomatic hypotensive episodes and nausea was not significantly different between the groups. On repeated measures ANOVA, changes in blood urea over time showed significant group effect. <b><i>Conclusions:</i></b> Predialytic supplementation was associated with better dialysis adequacy and urea removal than intradialytic supplementation. However, both timings were equally tolerated and not associated with underdialysis.

scholarly journals Different Visual Weighting due to Fast or Slow Vestibular Deafferentation: Before and after Schwannoma Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Fredrik Tjernström ◽  
Per-Anders Fransson ◽  
Babar Kahlon ◽  
Mikael Karlberg ◽  
Sven Lindberg ◽  
...  
Keyword(s):  
Postural Control ◽  
Spatial Orientation ◽  
Visual Cues ◽  
Time Course ◽  
Vestibular Function ◽  
Sensory Systems ◽  
Vestibular Loss ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. Feedback postural control depends upon information from somatosensation, vision, and the vestibular system that are weighted depending on their relative importance within the central nervous system. Following loss of any sensory component, the weighting changes, e.g., when suffering a vestibular loss, the most common notion is that patients become more dependent on visual cues for maintaining postural control. Dizziness and disequilibrium are common after surgery in schwannoma patients, which could be due to interpretation of the remaining sensory systems involved in feedback-dependent postural control and spatial orientation. Objective. To compare visual dependency in spatial orientation and postural control in patients suffering from unilateral vestibular loss within different time frames. Methods. Patients scheduled for schwannoma surgery: group 1 (n=27) with no vestibular function prior to surgery (lost through years), group 2 (n=12) with remaining vestibular function at the time of surgery (fast deafferentation), and group 3 (n=18) with remaining function that was lost through gentamicin installations in the middle ear (slow deafferentation). All patients performed vibratory posturography and rod and frame investigation before surgery and 6 months after surgery. Results. Postural control improved after surgery in patients that suffered a slow deafferentation (groups 1 and 3) (p<0.001). Patients that suffered fast loss of remaining vestibular function (group 2) became less visual field dependent after surgery (p≤0.035) and were less able to maintain stability compared with group 1 (p=0.010) and group 3 (p=0.010). Conclusions. The nature and time course of vestibular deafferentation influence the weighting of remaining sensory systems in order to maintain postural control and spatial orientation.

Effectiveness of ketamine in decreasing intracranial pressure in children with intracranial hypertension

2009 ◽  
Vol 4 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Gad Bar-Joseph ◽  
Yoav Guilburd ◽  
Ada Tamir ◽  
Joseph N. Guilburd
Keyword(s):  
Blood Pressure ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Repeated Measures ◽  
Intervention Group ◽  
Decrease Blood Pressure ◽  
Group 2 ◽  
Group 1

Object Deepening sedation is often needed in patients with intracranial hypertension. All widely used sedative and anesthetic agents (opioids, benzodiazepines, propofol, and barbiturates) decrease blood pressure and may therefore decrease cerebral perfusion pressure (CPP). Ketamine is a potent, safe, rapid-onset anesthetic agent that does not decrease blood pressure. However, ketamine's use in patients with traumatic brain injury and intracranial hypertension is precluded because it is widely stated that it increases intracranial pressure (ICP). Based on anecdotal clinical experience, the authors hypothesized that ketamine does not increase—but may rather decrease—ICP. Methods The authors conducted a prospective, controlled, clinical trial of data obtained in a pediatric intensive care unit of a regional trauma center. All patients were sedated and mechanically ventilated prior to inclusion in the study. Children with sustained, elevated ICP (> 18 mm Hg) resistant to first-tier therapies received a single ketamine dose (1–1.5 mg/kg) either to prevent further ICP increase during a potentially distressing intervention (Group 1) or as an additional measure to lower ICP (Group 2). Hemodynamic, ICP, and CPP values were recorded before ketamine administration, and repeated-measures analysis of variance was used to compare these values with those recorded every minute for 10 minutes following ketamine administration. Results The results of 82 ketamine administrations in 30 patients were analyzed. Overall, following ketamine administration, ICP decreased by 30% (from 25.8 ± 8.4 to 18.0 ± 8.5 mm Hg) (p < 0.001) and CPP increased from 54.4 ± 11.7 to 58.3 ± 13.4 mm Hg (p < 0.005). In Group 1, ICP decreased significantly following ketamine administration and increased by > 2 mm Hg during the distressing intervention in only 1 of 17 events. In Group 2, when ketamine was administered to lower persistent intracranial hypertension, ICP decreased by 33% (from 26.0 ± 9.1 to 17.5 ± 9.1 mm Hg) (p < 0.0001) following ketamine administration. Conclusions In ventilation-treated patients with intracranial hypertension, ketamine effectively decreased ICP and prevented untoward ICP elevations during potentially distressing interventions, without lowering blood pressure and CPP. These results refute the notion that ketamine increases ICP. Ketamine is a safe and effective drug for patients with traumatic brain injury and intracranial hypertension, and it can possibly be used safely in trauma emergency situations.

Influence of Movement Activities on Shape Recognition and Retention

1979 ◽  
Vol 48 (1) ◽  
pp. 116-118
Author(s):  
Carl P. Gabbard ◽  
Charles H. Shea
Keyword(s):  
Repeated Measures ◽  
Shape Recognition ◽  
Traditional Classroom ◽  
Assessment Instrument ◽  
Form Perception ◽  
Repeated Measures Analysis ◽  
Main Effect ◽  
Group 2 ◽  
Movement Activities ◽  
Group 1

Three groups of 4-yr.-old children were asked to complete a form perception assessment instrument prior to, 1 hr. after, and 1 wk. following a treatment. Group 1 participated in a movement-based form perception program, while Group 2 was instructed using a traditional classroom method. A third group which acted as control participated in unrelated movement activities. A repeated-measures analysis of variance gave a main effect of tests and an interaction of groups × tests. Group 2 displayed significantly higher performance on the posttest than Group 1; however, after 7 wk. the performance of Group 2 had decreased to a level below that of Groups 1 and 3, which remained stable.

scholarly journals ‘Comparison of Safety and Performance of Two Ophthalmic Viscosurgical Devices in Cataract Surgery’

2021 ◽  
Author(s):  
öznur işcan ◽  
Banu Torun Acar ◽  
Burcu Nurozler Tarakcı
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Sodium Hyaluronate ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
And Performance ◽  
Group 1

Abstract Purpose: To compare the safety and performance of two ophthalmic viscosurgical devices (OVDs) Bio-Hyalur SV (Sodium Hyaluronate 3.0%) (Biotech Healthcare Group, Luzern, Switzerland) and Protectalon (sodium hyaluronate 2.0%) (VSY Biotechnology, Turkey) in cataract surgery. Methods: One hundred twenty eyes of one hundred twenty patients who underwent phacoemulsification surgery were included in the study. Postoperatively sixty eyes using Bio-Hyalur-SV were classified as Group 1, and sixty eyes using Protectalon as Group 2. Patients aged 45 and over, Grade I, II or III unilateral / double stained cataract, healthy eyes creating cataract inclueded in this study . Endothelial cell morphological parameters including endothelial cell density (ECD), cell number, cell area, coefficient of variation (CV) in cell size, cell hexagonality and central corneal thickness (CCT) were measured preoperatively and at postoperative first week, first and third month visits.Intraocular pressure (IOP) was measured with an applanation tonometer at every visit. Results: . There was a statistically significant decrease in the mean ECD all follow-up times when compared with the preoperative visit (p=0.000). In terms of mean ECD levels there was no significant difference between the two groups within three months postoperatively (p=0.616) In the first week after surgery, there was an significant increase in CCT in Group 1 and Group 2 respectively (p=0.000). The IOP was <23 mmHg in all of the patients on the first day after surgery. There was no significant difference in the incidence of IOP peaks between the two groups in every vizits. In both groups, a significant increase was observed in the mean IOP at first day, first week, and first month after surgery compared to preoperative values (p=0.000). But no significant difference in IOP increase in Group 1 (P=0.092), Group 2 (P=0.013) compared to preoperative values ​​at third month postoperatively (p <0.001 significant with Bonferrotti correction). Conclusion: The two OVD’s used in this study during cataract surgery were safe and effective. Both OVD’s resulted in similar rates of transient IOP increases and corneal endothelial damage also provided good anterior chamber depth and were fairly easy to remove.

scholarly journals Correlation of Corneal Thickness Measurements Between Tono-pachymeter and Scheimpflug- Placido Topography

2021 ◽  
Vol 16 (2) ◽  
pp. 161-167
Author(s):  
Zeynep Eylül Ercan ◽  
Keyword(s):  
Corneal Thickness ◽  
Age Groups ◽  
Limits Of Agreement ◽  
Altman Plot ◽  
Bland Altman Plot ◽  
Significant Relationships ◽  
Plot Analysis ◽  
Group 2 ◽  
Thickness Measurements ◽  
Group 1

Central corneal thickness (CCT) measurements are important for diagnosis, treatment, and surgery planning in ophthalmology. The purpose of this study was to see whether CCT measurements taken with Tono-pachymeter and Scheimpflug- Placido Topography had any significant differences. Tono-pachymeter and topography CCT measurements were taken (n=400). Inter-measurement agreement between them was determined using Bland-Altman Plot analysis. Age groups were also formed as group 1 (aged 18-50 years, 94 males, 106 females) and group 2 (age >51 years, 100 males, 100 females). Mean CCTs measured by Tonopachymeter and topography were 563.77 +±26.43 and 560.88 + 26.341 microns. Bland-Altman Plot analysis showed in total, 13 were above the upper limit and 5 were under the minimum limit of agreement with regression analysis showing no significant relationships (p=0.213). Group 1 had 7 above and 2 below from the limits of agreement. Group two had 9 above and 2 below from the limits of agreement. Both groups showed insignificant differences between devices (p=0.07 and p=0.86). Tono-pachymeter and Scheimpflug-Placido Topography give reliable CCT results within each other. However, since the limit of agreement ranges can still affect one-to-one patient evaluations, we recommend clinics that use these devices to not interchange measurements in practice.

Learner proficiency and EFL learning through task rehearsal and performance

2019 ◽  
Vol 24 (5) ◽  
pp. 588-615
Author(s):  
Bao Trang Thi Nguyen ◽  
Jonathan Newton
Keyword(s):  
Foreign Language ◽  
Teaching And Learning ◽  
Language Problems ◽  
Total Data ◽  
Group 3 ◽  
Group 2 ◽  
And Performance ◽  
The Impact ◽  
Problem Solving Task ◽  
Group 1

This study examined the impact of learner proficiency on the occurrence and resolution of language-related episodes (LREs) in rehearsal of interactive speaking tasks and on the subsequent use of language items from LREs during performance of the same tasks in front of the class. Forty-eight learners from six intact English as a foreign language (EFL) classes at a Vietnamese high school were divided into three proficiency groups, each consisting of eight dyads. Group 1 was higher proficiency (HH) dyads; Group 2 consisted of mixed proficiency dyads (HL) and Group 3 was lower proficiency (LL) dyads. All the pairs rehearsed and then consecutively performed a problem-solving task and a debate task in two separate classroom lessons. The total data included 48 rehearsals and 48 corresponding performances collected during normal classroom hours. The results show that, overall, LL dyads encountered more language problems (more LREs) in rehearsal than HH dyads and they were less likely to resolve them successfully. However, they were able to use a majority of the correct resolutions in the performance as well as their higher proficiency counterparts. The lower proficiency learners were also found to employ memorizing and local rehearsing strategies to retain ideas and language items as they rehearsed for the upcoming performance. These findings have pedagogical implications for teaching and learning through tasks in EFL contexts and beyond.

Randomised controlled study to assess skill retention at 6 vs 12 months after simulation training in shoulder dystocia

2017 ◽  
Vol 3 (4) ◽  
pp. 142-148
Author(s):  
Menelik M H Lee ◽  
Chao Ngan Chan ◽  
Betty Y T Lau ◽  
Teresa W L Ma
Keyword(s):  
Repeated Measures ◽  
Significant Interaction ◽  
Simulation Training ◽  
Shoulder Dystocia ◽  
Current Evidence ◽  
Controlled Study ◽  
Testing Time ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

IntroductionCurrent evidence suggests annual training in the management of shoulder dystocia is adequate. The aim of this trial is to test our hypothesis that skills start to decline at 6 months after training and further decline at 12 months.MethodsIn this randomised, single-blinded study, 13 obstetricians and 51 midwives were randomly assigned to attend a 1-hour mixed lecture and simulation session on shoulder dystocia management. Training was conducted on group 2 at month ‘0’ and on group 1 at month ‘6’. Their knowledge scores (primary outcome) were assessed before (pre-training), immediately after the training (at-training) and retested at month ‘12’ (post-training).ResultsTwo-way repeated-measures analysis of variance showed a statistically significant interaction between the testing time frame (pre-training, at-training and post-training) on the score (p<0.001), but no significant interaction between the groups on the score (p=0.458).Compared to pre-training, the score increased after the simulation training (at-training) in both group 1 (8.69 vs 14.34, p<0.001) and group 2 (9.53 vs 14.66, p< 0.001), but decreased at 6 months post- training in group 1 (14.34 vs 11.71, p<0.001) and at 12 months post-training in group 2 (14.66 vs 11.96, p< 0.001). However the score was better than before the training. There was no significant difference in the post –training score (11.71vs 11.96, p=0.684) between both groups.ConclusionsOur study demonstrated that simulation training results in short-term and long-term improvement in shoulder dystocia management however knowledge degrades over time. Ongoing training is suggested at a minimum of 12 months’ interval for all members of the obstetrics team including midwives and doctors.

Characterizing fatigue associated with sunitinib (SU) in patients (pts) with metastatic renal cell carcinoma (mRCC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6092-6092
Author(s):  
David Cella ◽  
Mellar P. Davis ◽  
Andrew G. Bushmakin ◽  
Joseph C Cappelleri ◽  
Elizabeth A Hahn ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Rating Scale ◽  
Rate Of Change ◽  
Initial Increase ◽  
Time Pattern ◽  
Mean Values ◽  
Patient Reported ◽  
Group 2 ◽  
Group 1 ◽  
Cycle Fluctuation

6092 Background: Fatigue is common in cancer pts and associated with use of tyrosine kinase inhibitors (TKIs) such as SU. Limited data exist on the time pattern of fatigue with TKI therapy. Methods: Data from treatment-naïve mRCC pts in SU arms of two clinical trials were analyzed retrospectively. Study 1; 375 pts were randomized to SU 50 mg/d on a 4 weeks-on-2-weeks-off schedule (Schedule 4/2), for up to 30 cycles. Study 2; pts were randomized to SU 50 mg/d Schedule 4/2 (Group 1; n=146) or 37.5 mg/d continuous daily dosing (CDD; Group 2; n=146). In both trials, fatigue was measured with the question to pts: “I feel fatigued” over the past week (5-point rating scale, not at all-very much), and with the provider-rated Common Terminology Criteria for Adverse Events (CTCAE). In addition to descriptive profiles, Study 1 used two modeling approaches; repeated measures model (M1), with time as a categorical predictor; and random intercept-slope model (M2), with time as a continuous predictor. Study 2 calculated mean absolute values of within-cycle rate of change (from one assessment to the next) through the first 6 treatment cycles. Results: In Study 1, representing fatigue across cycles, M1 showed that the initial increase in patient-reported fatigue was worst during Cycle 1; mean values at all subsequent cycles were numerically better. For CTCAE fatigue, M1 showed that all but one of the pair-wise comparisons of the cycle means were not significantly different. M2 showed that the overall trend for patient-reported fatigue and CTCAE fatigue was not statistically different from zero. In Study 2, the mean absolute rate of change for fatigue during 6 treatment cycles was greater for Group 1 (4/2) compared to Group 2 (CDD): 0.042 vs. 0.032, respectively; P=0.003, t-test. Conclusions: In Study 1, pts reported notable fatigue in Cycle 1, which improved or stabilized, thereafter. In Study 2, Schedule 4/2 was associated with more within-cycle fluctuation in fatigue. These findings illustrate how SU-associated fatigue occurs early in therapy and continues with more within-cycle fluctuation associated with 4/2 dosing. This may help patient-clinician communications and interventions that support maintaining effective therapy.

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