scholarly journals Preliminary Evaluation of an Adaptive Robotic Training Program of the Wrist for Persons with Multiple Sclerosis

2021 ◽  
Vol 11 (19) ◽  
pp. 9239
Author(s):  
Kailynn Mannella ◽  
Giulia A. Albanese ◽  
David Ditor ◽  
Jacopo Zenzeri ◽  
Michael W. R. Holmes
Keyword(s):  
Multiple Sclerosis ◽  
Training Program ◽  
Upper Extremity ◽  
Neuromuscular Control ◽  
Preliminary Evaluation ◽  
Training Algorithms ◽  
Robotic Device ◽  
Robotic Training ◽  
Post Intervention ◽  
Motor Accuracy

Robotics can be used to describe wrist kinematics and assess sensorimotor impairments, while the implementation of training algorithms can be aimed at improving neuromuscular control. The purpose of this study was to use a robotic device to develop an adaptive and individualized training program of the distal upper extremity for individuals with multiple sclerosis (MS). This approach included an online assessment of performance aimed at changing the level of assistance/resistance provided during the task. Participants (N = 7) completed a robotic training program that occurred 3 times weekly for 4 weeks. The training protocol consisted of tracking a target moving along a figure by grasping the end-effector of the robotic device and moving it along the trajectory. Outcome measures were assessed pre- and post-intervention. Improvements in performance were quantified by average tracking (p = 0.028) and figural error (p = 0.028), which was significantly reduced by 26% and 43%, respectively. Isometric wrist strength significantly improved post-intervention (flexion: p = 0.043, radial and ulnar deviation: p = 0.028). The results of this work demonstrate that 4-weeks of adaptive robotic training is a feasible rehabilitative program that has the potential to improve distal upper extremity motor accuracy and muscular strength in a MS population.

An effectiveness of training program on COVID-19 among healthcare students: A cross section study

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1250-1254
Author(s):  
Kurvatteppa Halemani ◽  
Merlin Cheema ◽  
Shabana Khatun ◽  
Yadidya ◽  
Bhumika Singh ◽  
...  
Keyword(s):  
Nursing Students ◽  
Training Program ◽  
Cross Section ◽  
Sampling Technique ◽  
Teaching Session ◽  
Post Intervention ◽  
Post Test ◽  
College Of Nursing ◽  
Novel Coronavirus ◽  
First Time

The pandemic COVID-19 is a highly infected disease caused by a novel coronavirus or SARS-Cov-2. The virus was reported for the first time  December 2019 in, China's Wuhan province. Later the virus has broken down into the world and claimed millions of lives. In India, the disease was reported for the first time in Kerala on 30th January 2020. a cross-section one group pre-test & post-test research design was used among the 40 final year BSc nursing students, College of Nursing SGPGIMS, Lucknow India. Samples were selected based on purposive sampling technique and sample criteria. An instrument, the first tool included demographic characteristics Similarly, second instrument used for knowledge assessment. After pre-test assessment, a teaching session was held at the seminar room, college of nursing SGPGIMS Lucknow, India. Subsequently post assessment was held after intervention.  A total of 40 participants responded to the study. Demographic variables like 30(75%) participants had less than 22 years of age, 22(55%) were girls, 14(35%) families income found INR 10000-15000, and the majority of participants obtained COVID-19 related knowledge from news paper16(40%). A gender was found significant with pretest knowledge, and other variables weren't found significant (P=0.05). Knowledge mean & standard deviation in pre & post-intervention, 11.90±2.16 vs15.82±1.39. The mean difference was found in a pre-test & post-test-1 &post-test-2, 3.9, 5.02, & 1.1, respectively. The effectiveness of the training program was checked by paired t-test -10.20 & -13.93, P=0.00.  The study revealed that the teaching session was efficient in the COVID-19 program among BSc nursing students.

Upper Extremity Motor Fatigability as an Early Indicator in Pediatric Onset Multiple Sclerosis

2021 ◽  
pp. 088307382199988
Author(s):  
Giuseppina Pilloni ◽  
Martin Malik ◽  
Raghav Malik ◽  
Lauren Krupp ◽  
Leigh Charvet
Keyword(s):  
Multiple Sclerosis ◽  
Grip Strength ◽  
Upper Extremity ◽  
Static Fatigue ◽  
Healthy Controls ◽  
Fatigue Index ◽  
Left Hand ◽  
Right Hand ◽  
Computer Based ◽  
Pediatric Onset

Aim: To adopt a computer-based protocol to assess grip fatigability in patients with pediatric-onset multiple sclerosis to provide detection of subtle motor involvement identifying those patients most at risk for future decline. Method: Pediatric-onset multiple sclerosis patients were recruited during routine outpatient visits to complete a grip assessment and compared to a group of healthy age- and sex-matched controls. All participants completed a computer-based measurement of standard maximal grip strength and repetitive and sustained grip performance measured by dynamic and static fatigue indices. Results: A total of 38 patients with pediatric-onset multiple sclerosis and 24 healthy controls completed the grip protocol (right-hand dominant). There were no significant group differences in maximal grip strength bilaterally (right: 21.8 vs 19.9 kg, P = .25; left: 20.4 vs 18.7 kg, P = .33), although males with pediatric-onset multiple sclerosis were significantly less strong than healthy controls (right: 26.53 vs 21.23 kg, P = .009; left; 25.13 vs 19.63 kg, P = .003). Both dynamic and static fatigue indices were significantly higher bilaterally in pediatric-onset multiple sclerosis compared with healthy control participants (left-hand dynamic fatigue index: 18.6% vs 26.7%, P = .003; right-hand static fatigue index: 28.3% vs 41.3%, P < .001; left-hand static fatigue index: 31.9% vs 42.6%, P < .001). Conclusion: Brief repeatable grip assessment including measures of dynamic and sustained static output can be a sensitive indicator of upper extremity motor involvement in pediatric-onset multiple sclerosis, potentially identifying those in need of intervention to prevent future disability.

Using Real-Time Feedback with Motion Capture to Measure Upper Extremity Workspace: a Preliminary Evaluation

2021 ◽  
Author(s):  
R. Tyler ◽  
Stephanie Russo ◽  
Ross Chafetz ◽  
Spencer Warshauer ◽  
Emily Nice ◽  
...  
Keyword(s):  
Real Time ◽  
Upper Extremity ◽  
Motion Capture ◽  
Preliminary Evaluation

scholarly journals Relationship between Physical Disability and Black Holes in Multiple Sclerosis: Upper Extremity Functions - an Important Parameter

2021 ◽  
Vol 1 (1) ◽  
pp. 17-21
Author(s):  
Bilge Piri Cinar ◽  
Gülcan Kalaycı ◽  
Mustafa Acikgoz ◽  
Serkan Ozakbas
Keyword(s):  
Multiple Sclerosis ◽  
Black Holes ◽  
Upper Extremity ◽  
Physical Disability

scholarly journals Preliminary Evaluation of the Engagement and Effectiveness of a Mental Health Chatbot

2020 ◽  
Author(s):  
Kate Daley
Keyword(s):  
Mental Health ◽  
Digital Health ◽  
Preliminary Evaluation ◽  
Real World Data ◽  
Post Intervention ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cohen’S D ◽  
Cohen's D ◽  
Human Support

Background: Mental health difficulties are highly prevalent yet access to support is impeded by barriers of stigma, cost and availability. These issues are even more prevalent in low- and middle-income countries, and use of digital technology is one way to overcome these barriers. Digital health interventions have been shown to be effective but often struggle with low engagement rates, particularly in the absence of any human support. Chatbots could offer a scalable solution, simulating human support at a lower cost. Objective: To complete a preliminary evaluation of engagement and effectiveness of Vitalk, a mental health chatbot, at reducing anxiety, depression and stress. Methods: Real world data was analysed from 3629 Vitalk users who had completed the first phase of a Vitalk program (‘less anxiety’, ‘less stress’ or ‘better mood’). Programs were delivered through written conversation with the chatbot. Engagement was calculated from the number of responses sent to the chatbot divided by days in the program. Results: Users sent an average of 8.17 responses / day. For all three programs, target outcome scores reduced between baseline and follow up with large effect sizes for anxiety (Cohen's d = -0.85), depression (Cohen's d = -0.91) and stress (Cohen's d =-0.81). Increased engagement resulted in improved post-intervention values for anxiety and depression. Conclusion: This study highlights the potential of a chatbot to reduce mental health symptoms in the general population within Brazil. Whilst findings show promise, further research is required.

scholarly journals Improvement of Physical Performance Following a 6 Week Change-of-Direction Training Program in Elite Youth Soccer Players of Different Maturity Levels

2021 ◽  
Vol 12 ◽  
Author(s):  
Dorsaf Sariati ◽  
Raouf Hammami ◽  
Hassane Zouhal ◽  
Cain C. T. Clark ◽  
Ammar Nebigh ◽  
...  
Keyword(s):  
Training Program ◽  
Effect Size ◽  
Soccer Players ◽  
Height Velocity ◽  
Adherence Rate ◽  
Peak Height Velocity ◽  
Post Intervention ◽  
Significant Group ◽  
Youth Soccer ◽  
Change Of Direction

Background: Change-of-direction (CoD) is a necessary physical ability of a field sport and may vary in youth players according to their maturation status.Objectives: The aim of this study is: to compare the effectiveness of a 6-week CoD training intervention on dynamic balance (CS-YBT), horizontal jump (5JT), speed (10 and 30-m linear sprint times), CoD with (15 m-CoD + B) and without (15 m-CoD) the ball, in youth male soccer players at different levels of maturity [pre- and post-peak height velocity (PHV)].Materials and Methods: Thirty elite male youth soccer players aged 10–17 years from the Tunisian first division participated in this study. The players were divided into pre- (G1, n = 15) and post-PHV (G2, n = 15) groups. Both groups completed a similar 6-week training program with two sessions per week of four CoD exercises. All players completed the following tests before and after intervention: CS-YBT; 5 JT; 10, 30, and 15 m-CoD; and 15 m-CoD + B, and data were analyzed using ANCOVA.Results: All 30 players completed the study according to the study design and methodology. Adherence rate was 100% across all groups, and no training or test-related injuries were reported. Pre-PHV and post-PHV groups showed significant amelioration post-intervention for all dependent variables (after test &gt; before test; p &lt; 0.01, d = 0.09–1.51). ANOVA revealed a significant group × time interaction only for CS-YBT (F = 4.45; p &lt; 0.04; η2 = 0.14), 5JT (F = 6.39; p &lt; 0.02; η2 = 0.18), and 15 m-CoD (F = 7.88; p &lt; 0.01; η2 = 0.22). CS-YBT, 5JT, and 15 m-CoD improved significantly in the post-PHV group (+ 4.56%, effect size = 1.51; + 4.51%, effect size = 1.05; and -3.08%, effect size = 0.51, respectively), more than the pre-PHV group (+ 2.77%, effect size = 0.85; + 2.91%, effect size = 0.54; and -1.56%, effect size = 0.20, respectively).Conclusion: The CoD training program improved balance, horizontal jump, and CoD without the ball in male preadolescent and adolescent soccer players, and this improvement was greater in the post-PHV players. The maturity status of the athletes should be considered when programming CoD training for soccer players.

scholarly journals Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial

2017 ◽  
Vol 23 (11) ◽  
pp. 1517-1526 ◽  
Author(s):  
Martin Heine ◽  
Olaf Verschuren ◽  
Erwin LJ Hoogervorst ◽  
Erik van Munster ◽  
Hub GA Hacking ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Aerobic Training ◽  
Controlled Trial ◽  
Post Intervention ◽  
Intensity Control ◽  
Control Intervention ◽  
Severe Fatigue ◽  
Disability Status ◽  
Checklist Individual Strength ◽  
Societal Participation

Background: Evidence supporting the effectiveness of aerobic training, specific for fatigue, in severely fatigued patients with multiple sclerosis (MS) is lacking. Objective: To estimate the effectiveness of aerobic training on MS-related fatigue and societal participation in ambulant patients with severe MS-related fatigue. Methods: Patients ( N = 90) with severe MS-related fatigue were allocated to 16-week aerobic training or control intervention. Primary outcomes were perceived fatigue (Checklist Individual Strength (CIS20r) fatigue subscale) and societal participation. An improvement of ⩾8 points on the CIS20r fatigue subscale was considered clinically relevant. Outcomes were assessed by a blinded observer at baseline, 2, 4, 6 and 12 months. Results: Of the 89 patients that started treatment (median Expanded Disability Status Scale (interquartile range), 3.0 (2.0–3.6); mean CIS20r fatigue subscale (standard deviation (SD)), 42.6 (8.0)), 43 received aerobic training and 46 received the control intervention. A significant post-intervention between-group mean difference (MD) on the CIS20r fatigue subscale of 4.708 (95% confidence interval (CI) = 1.003–8.412; p  = 0.014) points was found in favour of aerobic training that, however, was not sustained during follow-up. No effect was found on societal participation. Conclusion: Aerobic training in MS patients with severe fatigue does not lead to a clinically meaningful reduction in fatigue or societal participation when compared to a low-intensity control intervention.

Poster 147 Perceived Effort and Cardiovascular Response to Upper-Extremity Challenge in Individuals with Multiple Sclerosis

2011 ◽  
Vol 92 (10) ◽  
pp. 1734
Author(s):  
Brad Sokal ◽  
Gitendra Uswatte ◽  
Rex Wright ◽  
Edward Taub ◽  
Victor Mark ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Upper Extremity ◽  
Cardiovascular Response ◽  
Perceived Effort

scholarly journals Trends in Route of Hysterectomy after the Implementation of a Comprehensive Robotic Training Program

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Eleni Papalekas ◽  
Jay Fisher
Keyword(s):  
Robotic Surgery ◽  
Training Program ◽  
Teaching Hospital ◽  
Community Hospital ◽  
Tertiary Care ◽  
Monitoring Program ◽  
Teaching Hospitals ◽  
Robotic Training ◽  
Abdominal Approach ◽  
National Trends

Objective. To evaluate trends in surgical approach for hysterectomy following the introduction and implementation of a comprehensive robotic surgery program. Methods. A retrospective review of all hysterectomies done at two institutions, a community hospital and a suburban, tertiary-care teaching hospital, in the same health system over a five-year period, January 2010 through December 2014. A robotic surgery training program was implemented during the first year of the study and trends in route of hysterectomy were evaluated in the subsequent years. Results. A total of 5175 patients undergoing hysterectomy, for both benign and malignant indications, were included in the study. There was a significant decrease in the percent of cases performed through an abdominal approach at both the community and teaching hospitals (19.3% decline at each institution). There was an inversely related significant increase in the percent of robotic procedures at both the community and teaching hospitals (44.5% and 17%, respectively). A decrease in number of cases performed vaginally over this period was only noted in the community hospital site (25.2% decrease), and there was a slightly higher rate of vaginal hysterectomies at the teaching hospital over this study period (21.9% in 2010, 24.1% in 2014). Conclusion. The decrease in number of abdominal and laparoscopic hysterectomies and increase in number of robotic hysterectomies that was seen are consistent with national trends. The initiation of a robotic training program did not prevent the proliferation of use of the robot but did aim to ensure proficiency on the robot prior to gaining privileges for patient use. This type of comprehensive training and monitoring program could be applied to future technologic advances to ensure a standard level of surgical proficiency. Trends in route of hysterectomy are clearly multifactorial and involve patient, provider, and location-specific factors that are likely to continue to change.

scholarly journals Protocol for a partially nested randomized controlled trial to evaluate the effectiveness of the Scleroderma Patient-centered Intervention Network Support Group Leader EDucation (SPIN-SSLED) Program

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Brett D. Thombs ◽  
◽  
Kylene Aguila ◽  
Laura Dyas ◽  
Marie-Eve Carrier ◽  
...  
Keyword(s):  
Training Program ◽  
Support Groups ◽  
Support Group ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Group Leader ◽  
Group Leaders ◽  
Post Intervention ◽  
Patient Centered ◽  
Patient Support Group

Abstract Background Some people with rare diseases rely on peer-led support groups for disease-specific education and emotional and practical support. Systemic sclerosis (SSc), or scleroderma, is a rare autoimmune connective tissue disease. Many people with SSc cannot access support groups, and, when support groups exist, they may not be sustained due to challenges that could be addressed via leader training. The Scleroderma Patient-centered Intervention Network (SPIN), along with SSc patient organization partners, developed a training program for SSc patient support group leaders, the Scleroderma Support group Leader EDucation (SPIN-SSLED) Program. We recently completed a feasibility trial in which we successfully delivered the program to two groups of support group leaders who reported a high level of satisfaction with the program and its delivery. The primary objective of the full-scale SPIN-SSLED trial is to evaluate the effect of the program on support group leaders’ self-efficacy for carrying out their leadership role. Secondary objectives include evaluating effects on leader burnout, leader satisfaction (participation efficacy), and emotional distress. Methods/design The SPIN-SSLED trial is a pragmatic randomized controlled trial (RCT) in which 180 support group leaders will be randomly allocated to training groups of 6 participants each or to a waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups, but not in the waitlist control. Participants allocated to the training program will receive the 13-module SPIN-SSLED Program, delivered via webinar over the course of 3 months in weekly 60–90-min sessions. The primary outcome is leader self-efficacy, measured by the Scleroderma Support Group Leader Self-efficacy Scale post-intervention. Secondary outcomes are leader self-efficacy at 3 months post-intervention, and leader burnout, volunteer job satisfaction (participation efficacy), and emotional distress post-intervention and at 3 months post-intervention. Discussion The SPIN-SSLED trial will test whether a training program for SSc patient support group leaders increases the self-efficacy of group leaders to carry out leadership tasks. The program has the potential to significantly improve the effectiveness and sustainability of existing SSc support groups, to increase the number of available support groups, and to be adapted for other chronic diseases. Trial registration ClinicalTrials.gov, NCT03965780. Registered on 29 May 2019.

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