The Effect of Knee Flexion on Active and Passive Popliteal Venous Flow When Using Crutches or Knee Scooter While Immobilized

Category: Trauma; Other Introduction/Purpose: Knee flexion has been demonstrated to impede popliteal venous return with large effect size among patients lying supine for surgery. Passive popliteal flow impedance has also been suggested to occur with knee scooter usage due to knee flexion. This study compared the effect of knee flexion angles on popliteal venous return between upright, crutch and knee scooter positioning when immobilized. Further, the countervailing effect of standardized hallux musculovenous pump activation was observed. Methods: This was an IRB approved study of young, healthy volunteers. Popliteal venous diameter and flow metrics were assessed with venous ultrasonography and compared between straight leg, crutch, and knee scooter positioning while wearing a walking boot and nonweightbearing. Flow was assessed with muscles at rest and with hallux musculovenous pump activation via active oscillation between hallux metatarsophalangeal joint extension and flexion at one motion per second (0.5 Hz) as paced by a metronome. Observer consistency was assessed. Paired-sample Student’s t-test and the Wilcoxon signed rank tests were used to assess within-subject differences for diameter and venous flow parameters, respectively. Knee flexion and musculovenous pump activation effects sizes were calculated. A priori sample size indicated 24 subjects were needed to achieve 80% power to detect a significant ( p < 0.006 ) difference in medial flow for any of 8 comparisons, assuming large effect sizes. Results: 16 of 24 (67%) subjects were female. Twelve limbs (50%) were right sided. The mean age was 21.9 years (SD 3.0 years) and the mean body mass index was 21.9 (SD 1.9). Observer consistencies were excellent (0.93 to 0.99). No significant differences in mean vessel diameter, time-averaged mean velocity, and total volume flow occurred. Corresponding knee flexion effect sizes were small (range -0.04 to -0.26). A significant decrease (-24%) in active median time-averaged peak velocity (TAPV) occurred between upright and crutch position (20.89 cm/s vs. 15.92 cm/s, p < 0.001) with a medium effect size (-0.51). Hallux musculovenous pump increased all flow parameters (all p< 0.001) and effect sizes were comparatively larger (>0.6) across all knee flexion positions. Conclusion: Compared to values reported for supine individuals, upright passive popliteal venous return was observed to be markedly diminished at all knee flexion angles. Knee flexion had minimal effect on diameter, a small effect in further diminishing TAMV and TVF and a medium effect on diminishing TAPV. Hallux musculovenous pump activiation had a large effect on increasing flow at all knee flexion angles. Patients may well be counseled to use toe motion to counter the negative effects of gravity, and to a lesser extent knee flexion, when using crutches and knee scooters while their ankle is immobilized.

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Pedal Musculovenous Pump Activation Effectively Counteracts Negative Impact of Knee Flexion on Human Popliteal Venous Flow

Foot & Ankle Specialist ◽

10.1177/1938640021997275 ◽

2021 ◽

pp. 193864002199727

Author(s):

Christopher W. Reb ◽

Edward T. Haupt ◽

Robert A. Vander Griend ◽

Gregory C. Berlet

Keyword(s):

Knee Flexion ◽

Negative Impact ◽

Weight Bearing ◽

Intraclass Correlation ◽

Effect Sizes ◽

Medium Effect ◽

Small Range ◽

Mean Velocity ◽

Venous Flow ◽

The Mean

Knee scooters are commonly used for mobility instead of other devices. However, passive popliteal venous flow impedance has been observed with knee scooter usage ostensibly as a result of deep knee flexion. This study aimed to characterize the magnitude of impact knee flexion has on popliteal venous flow in relation to the degree of knee flexion when walking boot immobilized. Furthermore, the countervailing effect of standardized pedal musculovenous pump (PMP) activation was observed. Popliteal venous diameter and flow metrics were assessed with venous ultrasonography in 24 healthy individuals. Straight leg, crutch, and knee scooter positioning while wearing a walking boot and non–weight-bearing were compared. Flow was assessed with muscles at rest and with PMP activation. Of 24 participants, 16 (67%) were female. Twelve limbs (50%) were right sided. The mean age was 21.9 (SD = 3.0) years, and the mean body mass index was 21.9 (SD 1.9) kg/m2. Observer consistencies were excellent (intraclass correlation range = 0.93 to 0.99). No significant differences in mean vessel diameter, time-averaged mean velocity, and total volume flow occurred (all P > .01). Corresponding knee flexion effect sizes were small (range = −0.04 to −0.26). A significant decrease (−24%) in active median time-averaged peak velocity occurred between upright and crutch positions (20.89 vs 15.92 cm/s; P < .001) with a medium effect size (−0.51). PMP activation increased all flow parameters (all P < .001), and effect sizes were comparatively larger (>0.6) across all knee flexion positions. Clinical Significance: Knee flexion has a small to medium impact on popliteal venous return in healthy patients. Active toe motion effectively counters the negative effects of gravity and knee flexion when the ankle is immobilized. Levels of Evidence: Therapeutic, Level IV

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Effect sizes and test-retest reliability of the fMRI-based Neurologic Pain Signature

10.1101/2021.05.29.445964 ◽

2021 ◽

Author(s):

Xiaochun Han ◽

Yoni K. Ashar ◽

Philip Kragel ◽

Bogdan Petre ◽

Victoria Schelkun ◽

...

Keyword(s):

Individual Differences ◽

Effect Size ◽

Mental States ◽

Effect Sizes ◽

Medium Effect ◽

Retest Reliability ◽

Medium Effect Size ◽

Pain Reports ◽

Nociceptive Input ◽

Test Retest Reliability

Identifying biomarkers that predict mental states with large effect sizes and high test-retest reliability is a growing priority for fMRI research. We examined a well-established multivariate brain measure that tracks pain induced by nociceptive input, the Neurologic Pain Signature (NPS). In N = 295 participants across eight studies, NPS responses showed a very large effect size in predicting within-person single-trial pain reports (d = 1.45) and medium effect size in predicting individual differences in pain reports (d = 0.49, average r = 0.20). The NPS showed excellent short-term (within-day) test-retest reliability (ICC = 0.84, with average 69.5 trials/person). Reliability scaled with the number of trials within-person, with ≥60 trials required for excellent test-retest reliability. Reliability was comparable in two additional studies across 5-day (N = 29, ICC = 0.74, 30 trials/person) and 1-month (N = 40, ICC = 0.46, 5 trials/person) test-retest intervals. The combination of strong within-person correlations and only modest between-person correlations between the NPS and pain reports indicates that the two measures have different sources of between-person variance. The NPS is not a surrogate for individual differences in pain reports, but can serve as a reliable measure of pain-related physiology and mechanistic target for interventions.

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A Meta-Analytic Review of the Consequences of Stigma and Stereotype Threat for Individuals with Specific Learning Disabilities

10.31234/osf.io/bt7ew ◽

2021 ◽

Author(s):

Stephanie Haft ◽

Fumiko Hoeft

Keyword(s):

Learning Disabilities ◽

Stereotype Threat ◽

Psychological Adjustment ◽

Effect Size ◽

Academic Outcomes ◽

Specific Learning Disabilities ◽

Effect Sizes ◽

Medium Effect ◽

Related Stigma ◽

Specific Learning

Exposure to stigma and stereotype threat has shown detrimental effects on psychological and academic outcomes in numerous marginalized groups. Research has demonstrated that individuals with specific learning disabilities (SLDs) are vulnerable to stigmatization because of their SLDs. The purpose of this quantitative meta-analysis is to provide an estimation of the overall relationship between SLD-related stigma and psychological and academic outcomes in individuals with SLDs, as well as examine the overall effect size of SLD-related stereotype threat across studies. A total of seven effect sizes examining SLD stigma and psychological adjustment, two effect sizes examining SLD stigma and academic outcomes, and six effect sizes examining SLD stereotype threat across 13 studies were analyzed. Meta-analytic findings revealed that greater SLD stigma scores had a medium-sized and significant correlation with less optimal psychological adjustment (r=-.39, k=7, p<.0001). SLD stigma showed a weak association with academic outcomes (r=-.06, k=2, p=.59). The estimated mean effect size of stereotype threat manipulations in individuals with SLDs was g=0.49 (k=6, p<.030), reflecting a medium effect and overall poorer performance-related outcomes in conditions of high stereotype threat. Given the small number of studies, moderator analyses were unable to be performed and evidence for publication bias is equivocal. These findings highlight the need for more research on SLD-related stigma and stereotype threat, and suggest that these negative experiences be a target of intervention and support efforts for individuals with SLDs.

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An Online Mindful Parenting Training for Mothers Raising Toddlers: Assessment of Acceptability, Effectiveness, and Personal Goals

Mindfulness ◽

10.1007/s12671-020-01542-z ◽

2020 ◽

Author(s):

Myrthe G. B. M. Boekhorst ◽

Lianne P. Hulsbosch ◽

Ivan Nyklíček ◽

Viola Spek ◽

Anna Kastelein ◽

...

Keyword(s):

Effect Size ◽

Parental Stress ◽

Mental Health Problems ◽

Well Being ◽

Population Based ◽

Mindful Parenting ◽

Effect Sizes ◽

Medium Effect ◽

Personal Goals

Abstract Objectives Mindful parenting (MP) interventions show promising results, but they mostly target parents (of children) with mental health problems. This study examined an online MP intervention for mothers with toddlers in a population-based sample. Aims were to assess acceptability and effectiveness of the intervention for mothers with and without parental stress, and examine their predetermined personal goals. Methods The study included 157 mothers with toddlers from the general population of whom 73 reported parental stress. The mothers participated in an 8-week online MP training. Questionnaires were completed at waitlist, pretest, posttest, and follow-up. Results Mothers rated the training positively, although only 23.1% completed the training. Personal goals were analyzed qualitatively, establishing four different themes: attention, well-being, patience, and balance. Significant improvements in personal goals posttest and follow-up were found (large and very large effect size, respectively). We found no significant improvements from waitlist to pretest for all outcome variables, except personal goals (medium effect size). Mixed-linear model analyses showed significant improvements posttest and follow-up as compared to pretest regarding Self-compassion, Parental over-reactivity and Symptoms of anxiety and depression (small to medium effect sizes). There was an effect at posttest for Parenting problems, and for Parental role restriction at follow-up (small effect sizes). Levels of parental stress and theme of personal goal did not influence the effectiveness of the intervention. Conclusions The current study provides initial evidence that an online MP training could be an easily accessible, inexpensive, and valuable intervention for parents without an indication for a therapist-assisted intervention. Trial Registration Dutch Trial Register (NTR7401)

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HYSTERESIS AND VORTICES DYNAMICS IN A TURBULENT FLOW

International Journal of Bifurcation and Chaos ◽

10.1142/s0218127409024414 ◽

2009 ◽

Vol 19 (08) ◽

pp. 2695-2703 ◽

Cited By ~ 8

Author(s):

JAVIER BURGUETE ◽

ALBERTO DE LA TORRE

Keyword(s):

Turbulent Flow ◽

Additive Noise ◽

Potential Model ◽

Time Dependent ◽

Small Range ◽

Mean Velocity ◽

Fully Developed Turbulent Flow ◽

Bistable Regime ◽

The Mean

Recent results about the slow dynamics present in a fully developed turbulent flow are reported. In a previous paper [de la Torre & Burguete, 2007] we showed that the mean velocity field in a turbulent flow bifurcates subcritically breaking some symmetries of the problem and becomes time-dependent because of equatorial vortices moving with a precession movement. This subcriticality produces a bistable regime, whose main characteristics were successfully reproduced using a three-well potential model with additive noise. In this paper we present the characterization of the hysteresis region, not previously observed, in this bifurcation. This hysteresis appears only for an extremely small range of parameters.

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Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study

Psychological Medicine ◽

10.1017/s0033291710000607 ◽

2010 ◽

Vol 41 (1) ◽

pp. 163-173 ◽

Cited By ~ 135

Author(s):

O. Grynszpan ◽

S. Perbal ◽

A. Pelissolo ◽

P. Fossati ◽

R. Jouvent ◽

...

Keyword(s):

Social Cognition ◽

Effect Size ◽

Specific Effect ◽

Cognitive Remediation ◽

Effect Sizes ◽

Cognitive Domain ◽

Medium Effect ◽

Computer Assisted ◽

Cognitive Domains ◽

And Control

BackgroundCognitive remediation is frequently based on computerized training methods that target different cognitive deficits. The aim of this article was to assess the efficacy of computer-assisted cognitive remediation (CACR) in schizophrenia and to determine whether CACR enables selective treatment of specific cognitive domains.MethodA meta-analysis was performed on 16 randomized controlled trials evaluating CACR. The effect sizes of differences between CACR and control groups were computed and classified according to the cognitive domain assessed. The possible influences of four potential moderator variables were examined: participants' age, treatment duration, weekly frequency, and control condition type. To test the domain-specific effect, the intended goal of each study was determined and the effect sizes were sorted accordingly. The effect sizes of the cognitive domains explicitly targeted by the interventions were then compared with those that were not.ResultsCACR enhanced general cognition with a mean effect size of 0.38 [confidence interval (CI) 0.20–0.55]. A significant medium effect size of 0.64 (CI 0.29–0.99) was found for Social Cognition. Improvements were also significant in Verbal Memory, Working Memory, Attention/Vigilance and Speed of Processing with small effect sizes. Cognitive domains that were specifically targeted by the interventions did not yield higher effects than those that were not.ConclusionsThe results lend support to the efficacy of CACR with particular emphasis on Social Cognition. The difficulty in targeting specific domains suggests a ‘non-specific’ effect of CACR. These results are discussed in the light of the possible bias in remediation tasks due to computer interface design paradigms.

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Clinician Engagement In Feedback Informed Treatment (FIT) and Patient Outcomes

10.31219/osf.io/gsb4r ◽

2020 ◽

Author(s):

George (Jeb) S Brown ◽

Christophe Cazauvieilh

Keyword(s):

Effect Size ◽

Hierarchical Linear Model ◽

Outcome Data ◽

Effect Sizes ◽

First Year ◽

Multiple Outcome ◽

Informed Treatment ◽

The Mean ◽

Second Year ◽

Feedback Informed Treatment

Abstract: Aim, Methods, Results, DiscussionAim: This paper presents analyses of outcome data for 317 therapists treating 14,161 patients over a three-year period to determine if therapists’ effect sizes increased over time. Each therapist treated at least 5 patients in each of their first two years of using outcome measures. Multiple outcome questionnaires were employed. All measures also included a brief alliance scale administered concurrently. Method: A severity adjusted effect size was calculated for each patient using intake scores and diagnostic group as predictors. The mean severity adjusted effect size for each therapist was calculated for their first and second years of using the outcome tools. This was done using a hierarchical linear model to control for sample size in each year, with a minimum sample of 5 cases in each year. Therapist engagement in receiving feedback was measured by counting the number of times the therapist logged into the online platform to view their results in each of the two years.Results: Therapists who logged in the view their data at least 24 times in the second year (n=123; 37%) averaged .92 effect size compared to .82 effect size for those seen by therapists who reviewed their results less frequently (n=214; 63%). Login frequency during the first year was not predictive of effect size during the second year. Discussion: The data provides evidence that effect sizes can trend upwards with measurement and feedback. Therapists’ engagement in receiving feedback appears to increase the likelihood of effect size gain.

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Effect of Wall Properties on the Peristaltic Flow of a Non-Newtonian Fluid

Applied Bionics and Biomechanics ◽

10.1155/2014/802361 ◽

2014 ◽

Vol 11 (4) ◽

pp. 207-219 ◽

Cited By ~ 2

Author(s):

Maryiam Javed ◽

T. Hayat ◽

A. Alsaedi

Keyword(s):

Small Amplitude ◽

Peristaltic Flow ◽

Fluid Models ◽

Peristaltic Motion ◽

Mean Velocity ◽

Flow Parameters ◽

Wall Properties ◽

Burgers Fluid ◽

The Mean ◽

Parameters Of Interest

The effect of wall properties is analyzed on the peristaltic motion of a Burgers’ fluid. Sinusoidal waves are considered on the channel walls. Small amplitude assumption is taken into account to solve the required boundary value problem. Various flow parameters of interest are sketched and discussed through graphs. Comparative study of the mean velocity for different fluid models is presented the mean velocity is found maximum in viscous fluid when compared with the Maxwell, Oldroyd-B and Burgers’ fluids.

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An Examination of Effect Sizes and Statistical Power in Speech, Language, and Hearing Research

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00299 ◽

2020 ◽

Vol 63 (5) ◽

pp. 1572-1580

Author(s):

Laura Gaeta ◽

Christopher R. Brydges

Keyword(s):

Effect Size ◽

Statistical Power ◽

Effect Sizes ◽

Medium Effect ◽

Speech Language Pathology ◽

Sample Sizes ◽

Hearing Research ◽

Language Pathology ◽

Meta Analyses ◽

Published Research

Purpose The purpose was to examine and determine effect size distributions reported in published audiology and speech-language pathology research in order to provide researchers and clinicians with more relevant guidelines for the interpretation of potentially clinically meaningful findings. Method Cohen's d, Hedges' g, Pearson r, and sample sizes ( n = 1,387) were extracted from 32 meta-analyses in journals in speech-language pathology and audiology. Percentile ranks (25th, 50th, 75th) were calculated to determine estimates for small, medium, and large effect sizes, respectively. The median sample size was also used to explore statistical power for small, medium, and large effect sizes. Results For individual differences research, effect sizes of Pearson r = .24, .41, and .64 were found. For group differences, Cohen's d /Hedges' g = 0.25, 0.55, and 0.93. These values can be interpreted as small, medium, and large effect sizes in speech-language pathology and audiology. The majority of published research was inadequately powered to detect a medium effect size. Conclusions Effect size interpretations from published research in audiology and speech-language pathology were found to be underestimated based on Cohen's (1988, 1992) guidelines. Researchers in the field should consider using Pearson r = .25, .40, and .65 and Cohen's d /Hedges' g = 0.25, 0.55, and 0.95 as small, medium, and large effect sizes, respectively, and collect larger sample sizes to ensure that both significant and nonsignificant findings are robust and replicable.

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A-53 The Relationship between Age and TMT-A Performance in Patients with Heart Failure

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.71 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1095-1095

Author(s):

Nicholas S Lackey ◽

Natasha Nemanim ◽

Alexander O Hauson ◽

Eric J Connors ◽

Anna Pollard ◽

...

Keyword(s):

Heart Failure ◽

Effect Size ◽

Significant Proportion ◽

Effect Sizes ◽

Medium Effect ◽

Future Research ◽

Medium Effect Size ◽

Meta Regression ◽

The Impact ◽

The Relationship

Abstract Objective A previous meta-analysis utilized the Trail Making Test A (TMT-A) to measure the impact of heart failure (HF) on attention. A near medium effect size with moderate heterogeneity was observed, the HF group performed worse than healthy controls (HC). This study explores if the age of the HF group moderates differences in the performance of individuals with HF versus HC on TMT-A. Data Selection Two researchers searched eight databases, extracted data, and calculated effect sizes as part of a larger study. Inclusion criteria were: (a) adults with HF (New York Heart Association severity II or higher), (b) comparison to a HC group, (c) standardized neuropsychological/cognitive testing, and (d) adequate data to calculate effect sizes. Exclusion criteria were: (a) participants had other types of major organ failure, (b) the article was not in English, or (c) there was a risk of sample overlap with another included study. A total of six articles were included in this sub-study (Total HF n = 602 and HC n = 342). The unrestricted maximum likelihood computational model was used for the meta-regression. Data Synthesis Studies included in the meta-regression evidenced a statistically significant medium effect size estimate with moderate heterogeneity (k = 6, g = 0.636, p < 0.001, I2 = 56.85%). The meta-regression was statistically significant (slope = −0.0515, p = 0.0016, Qmodel = 9.86, df = 1, p = 0.0016). Conclusions Individuals with HF performed worse on the TMT-A than HC. Age accounted for a significant proportion of the observed heterogeneity in the meta-regression. Future research should examine the relationship of age on cognition in individuals with HF.

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