scholarly journals Impact of Self-Selected Customized Orthotics on Lower Limbs Biomechanics

2021 ◽  
Author(s):  
Benjamin Dourthe ◽  
Judith Osterloh ◽  
Vinzenz Von Tscharner ◽  
Sandro Nigg ◽  
Benno M. Nigg
Keyword(s):  
Isometric Contraction ◽  
Lower Limb ◽  
Statistical Significance ◽  
Lower Limbs ◽  
Patient Specific ◽  
Emg Activity ◽  
Post Intervention ◽  
Walking Intervention ◽  
Foot Arch ◽  
The Impact

Customized insoles are commonly prescribed to prevent or treat a variety of foot pathologies and to reduce foot and lower limb fatigue. Due to the patient-specific design and production of such orthotics, the concept of self-selected customized orthotics (SSCO) has recently been developed. The goal of this study was to assess the impact of SSCO technology on several physiological and biomechanical variables during uphill power walking. Thirty male participants underwent an uphill power walking intervention at constant speed in two insoles conditions (control and SSCO). The electromyographic (EMG) activity of their right gastrocnemii and vastii muscles was measured. Perceived fatigue was assessed every 5 minutes and the intervention stopped when the targeted fatigue level was reached. Baseline and post-intervention assessments were also performed. Sixty-three percent of the participants experienced an improvement in foot fatigue while wearing the SSCO. The foot arch seemed to collapse less when participants wore the SSCO, but statistical significance was not reached. The changes in mean EMG activity was not consistent between the 50% isometric contraction and the walking trial. In conclusion, while some interesting trends were observed when wearing SSCO, further investigations should be performed to try and reach statistical significance.

scholarly journals The Impact of a Short-Term Walking Intervention to Decrease Perceived Stress

2020 ◽  
Vol 34 (4) ◽  
Author(s):  
Katie J. Fischer
Keyword(s):  
Perceived Stress ◽  
Low Cost ◽  
Private University ◽  
Upper Midwest ◽  
Short Term ◽  
Post Intervention ◽  
University Employees ◽  
Walking Intervention ◽  
The Impact

This study examined a short-term, low-cost walking intervention developed and implemented at a small, private university in the upper Midwest. Results showed a significant decrease in perceived stress (pre-intervention PSQ mean = 0.41 ± 0.16 versus post-intervention PSQ mean = 0.30 ± 0.14, p <0.001), and a significant increase in daily steps (pre-intervention mean = 6,810 ± 2,544 versus post-intervention mean = 9,352 ± 2,825, p < 0.001). These results provide support for the effectiveness of a short-term walking intervention to increase daily steps and decrease perceived stress for university employees.

scholarly journals Assessment of Direct Oral Anticoagulant Prescribing and Monitoring Pre- and Post-Implementation of a Pharmacy Protocol at a Community Teaching Hospital

2017 ◽  
Vol 52 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Christina Miele ◽  
Mary Taylor ◽  
Aditi Shah
Keyword(s):  
Teaching Hospital ◽  
Vitamin K Antagonists ◽  
Intervention Group ◽  
Adult Patients ◽  
Patient Specific ◽  
Post Intervention ◽  
Appropriate Prescribing ◽  
The Impact ◽  
Post Intervention Group ◽  
Community Teaching

Background Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence. Objective The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol. Methods Data were collected on adult patients admitted to a community teaching hospital who received DOAC therapy for at least 2 days between January and March 2015 (pre-intervention group) and between January and March 2016 (post-intervention group). These data were analyzed to measure inappropriately prescribed DOACs, defined based on DOAC indication, renal function, drug interactions, and other pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was provided to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention groups to determine the impact of the pharmacist-driven service on appropriate DOAC prescribing. Results Fifty patients were analyzed in the pre-intervention group compared with 85 patients in the post-intervention group, with a total of 333 and 816 doses administered, respectively. Of the total doses administered, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (adjusted odds ratio [OR], 0.42, 95% CI, 0.19-0.96; p = 0.039). Conclusions Implementing a pharmacist-driven DOAC service significantly improved appropriate prescribing of these agents. Provider education regarding DOAC use is essential to further increase appropriate prescribing of DOACs, optimize patients' therapy, and prevent adverse drug events.

scholarly journals 0636 Using AI To Predict Future CPAP Adherence and the Impact of Behavioral and Technical Interventions

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A243-A243
Author(s):  
W Hevener ◽  
B Beine ◽  
J Woodruff ◽  
D Munafo ◽  
C Fernandez ◽  
...  
Keyword(s):  
Effect Size ◽  
Statistical Significance ◽  
Post Intervention ◽  
Cpap Adherence ◽  
Cohen’S D ◽  
Usage Patterns ◽  
Patient Outreach ◽  
Cohen's D ◽  
The Impact ◽  
Usage Data

Abstract Introduction Clinical management of CPAP adherence remains an ongoing challenge. Behavioral and technical interventions such as patient outreach, coaching, troubleshooting, and resupply may be deployed to positively impact adherence. Previous authors have described adherence phenotypes that retrospectively categorize patients by discrete usage patterns. We design an AI model that predictively categorizes patients into previously studied adherence phenotypes and analyzes the statistical significance and effect size of several types of interventions on subsequent CPAP adherence. Methods We collected a cross-sectional cohort of subjects (N = 13,917) with 455 days of daily CPAP usage data acquired. Patient outreach notes and resupply data were temporally synchronized with daily CPAP usage. Each 30-days of usage was categorized into one of four adherence phenotypes as defined by Aloia et al. (2008) including Good Users, Variable Users, Occasional Attempters, and Non-Users. Cross-validation was used to train and evaluate a Recurrent Neural Network model for predicting future adherence phenotypes based on the dynamics of prior usage patterns. Two-sided 95% bootstrap confidence intervals and Cohen’s d statistic were used to analyze the significance and effect size of changes in usage behavior 30-days before and after administration of several resupply interventions. Results The AI model predicted the next 30-day adherence phenotype with an average of 90% sensitivity, 96% specificity, 95% accuracy, and 0.83 Cohen’s Kappa. The AI model predicted the number of days of CPAP non-use, use under 4-hours, and use over 4-hours for the next 30-days with OLS Regression R-squared values of 0.94, 0.88, and 0.95 compared to ground truth. Ten resupply interventions were associated with statistically significant increases in adherence, and ranked by adherence effect size using Cohen’s d. The most impactful were new cushions or masks, with a mean post-intervention CPAP adherence increase of 7-14% observed in Variable User, Occasional Attempter, and Non-User groups. Conclusion The AI model applied past CPAP usage data to predict future adherence phenotypes and usage with high sensitivity and specificity. We identified resupply interventions that were associated with significant increases in adherence for struggling patients. This work demonstrates a novel application for AI to aid clinicians in maintaining CPAP adherence. Support  

scholarly journals Can a virtual microbiology simulation be as effective as the traditional Wetlab for pharmacy student education?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
L. Baumann-Birkbeck ◽  
S. Anoopkumar-Dukie ◽  
S. A. Khan ◽  
M. J. Cheesman ◽  
M. O’Donoghue ◽  
...  
Keyword(s):  
Learning Outcomes ◽  
Professional Education ◽  
Statistical Significance ◽  
Pharmacy Practice ◽  
Pharmacy Students ◽  
Technology Enhanced Learning ◽  
Multiple Choice Questions ◽  
Post Intervention ◽  
The Impact ◽  
Enhanced Learning

Abstract Background Pharmacy practice education requires the development of proficiencies and an understanding of clinical microbiology. Learning in this area could be delivered using practical laboratory exercises, or potentially, simulation-based education. Simulation has previously successfully enhanced learning in health professional education. The current global climate due to COVID-19 has further highlighted the important role of technology-enhanced learning in delivering outcomes that meet the requisite learning objectives of a course. The aim of the present study was to compare the impact of a commercially available virtual microbiology simulation (VUMIE™) with a traditional wet laboratory (wetlab) on learner knowledge, skills and confidence in a second-year integrated pharmacotherapeutics course for Bachelor of Pharmacy students. Methods A randomised, crossover study was employed to determine whether the simulation intervention (VUMIE™) improves learning outcomes (knowledge, skills and confidence) of pharmacy students, when compared to a traditional wetlab intervention. Each student completed three 1–2 h length sessions, for both the wetlab and VUMIE™ interventions (6 sessions total). Data was collected using surveys deployed at baseline (pre-interventions), post-intervention 1 or 2 (VUMIE™ or wetlab) and endpoint (post-interventions 1 and 2). Statistical analysis was conducted using SPSS Statistics 25 and Instat™ software. Results Response rates were approximately 50% at initial survey and approximately 25% at endpoint survey. VUMIE™ produced higher post-intervention knowledge scores for the multiple-choice questions compared to the wetlab, however, the highest score was achieved at endpoint. Both interventions produced statistically significant differences for mean scores compared to baseline (pre-VUMIE™ and wetlab) across the domains of knowledge, skills and confidence. VUMIE™ produced higher post-intervention mean scores for knowledge, skills and confidence compared to post-intervention mean scores for the wetlab, however there was no statistical significance between the mean score for the two interventions, thus the VUMIE™ activity produced learning outcomes comparable to the wetlab activity. Conclusion These findings suggest VUMIE™ provides similar effects on students’ knowledge, skills, and confidence as a wetlab. The simulation’s implementation was not cost-prohibitive, provided students with a physically and psychologically safe learning environment, and the benefit of being able to repeat activities, supporting deliberate practice.

scholarly journals The Effects of Different Vibration Frequencies, Amplitudes and Contraction Levels on Lower Limb Muscles during Graded Isometric Contractions Superimposed on Whole Body Vibration Stimulation

2018 ◽  
Author(s):  
Amit N. Pujari ◽  
Richard D. Neilson ◽  
Marco Cardinale
Keyword(s):  
Muscle Contraction ◽  
Isometric Contraction ◽  
Whole Body Vibration ◽  
Lower Limbs ◽  
Whole Body ◽  
Emg Activity ◽  
Isometric Contractions ◽  
Body Vibration ◽  
Neuromuscular Activity ◽  
Co Activation

AbstractBackgroundIndirect vibration stimulation i.e. whole body vibration or upper limb vibration, has been suggested increasingly as an effective exercise intervention for sports and rehabilitation applications. However, there is a lack of evidence regarding the effects of whole body vibration (WBV) stimulation superimposed to graded isometric contractions superimposed on. For this scope, we investigated the effects of WBV superimposed to graded isometric contractions in the lower limbs on muscle activation. We also assessed the agonist-antagonist co-activation during this type of exercise.Twelve healthy volunteers were exposed to WBV superimposed to graded isometric contractions, at 20, 40, 60, 80 and 100% of the maximum voluntary contractions (V) or just isometric contractions performed on a custom designed horizontal leg press Control (C). Tested stimulation consisted of 30Hzand 50Hz frequencies and 0.5mm and 1.5mm amplitudes. Surface electromyographic activity of Vastus Lateralis (VL), Vastus Medialis (VM) and Biceps Femoris (BF) were measured during V and C conditions. Co-contraction activity of agonist-antagonist muscles was also quantified. The trials were performed in random order.ResultsBoth the prime mover, (VL) and the antagonist, (BF) displayed significantly higher (P < 0.05) EMG activity with the V than the C condition. For both the VL and BF, the increase in mean EMGrms values depended on the frequency, amplitude and muscle contraction level with 50Hz-0.5mm stimulation inducing the largest neuromuscular activity. 50Hz-0.5mm V condition also led to co-activation ratios significantly (P< 0.05) higher at 40, 80 and 100% of MVC than the C condition.ConclusionsOur results show that the isometric contraction superimposed on vibration stimulation leads to higher neuromuscular activity compared to isometric contraction alone in the lower limbs. Compared to the control condition, the vibratory stimulation leads to higher agonist-antagonist co-activation of the muscles around the knee joint in all vibration conditions and effort levels. The combination of vibration magnitude (frequency and amplitude) and the level of muscle contraction affect neuromuscular activity rather than vibration frequency alone. Results of this study suggest that more parameters need to be taken into consideration when designing vibration exercise programs for sports and rehabilitation purposes.

scholarly journals INTRAOPERATIONAL CORRECTION OF HAEMODYNAMIC DISTURBANCES IN PATIENTS UNDERGOING LAPAROSCOPIC SURGERY FOR HIATAL HERNIA

2017 ◽  
Vol 8 (1) ◽  
pp. 40-45
Author(s):  
M A Burikov ◽  
I I Katelnitsky ◽  
I V Skazkin ◽  
L L Timofeeva
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Technique ◽  
Hiatal Hernia ◽  
Lower Limb ◽  
Lower Limbs ◽  
Venous Diameter ◽  
The Impact

The aim of the article is to review the results of regional lower limb haemodynamics, haemostatic disturbances in patients undergoing laparoscopic surgery for hiatal hernia and intermittent pneumocompression in terms of embolism prevention. The impact of laparoscopic surgical technique on linear bloodflow velocity and venous diameter in lower limbs.

scholarly journals Pilot Study: Evaluating the Impact of Pharmacist Patient-Specific Medication Recommendations for Diabetes Mellitus Therapy to Family Medicine Residents

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 158
Author(s):  
Camlyn Masuda ◽  
Rachel Randall ◽  
Marina Ortiz
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Family Medicine ◽  
Statistical Significance ◽  
Diabetes Education ◽  
Office Visit ◽  
Patient Specific ◽  
Patients With Diabetes ◽  
The Impact ◽  
Family Medicine Residents

Pharmacists have demonstrated effectiveness in managing diabetes mellitus (DM) and lowering hemoglobin A1C (A1C) through direct patient management. Often patients with diabetes and elevated A1C may not be able to come into the clinic for separate appointments with a pharmacist or for diabetes education classes. A novel way that pharmacists can assist in improving the control of patients’ diabetes and improve prescriber understanding and the use of medications for diabetes is by providing medication recommendations to medical residents prior to the patient’s appointment with the medical resident. The results of this pilot study indicate that the recommendations provided to family medicine residents and implemented at the patient’s office visit helped to lower A1C levels, although the population size was too small to show statistical significance. This pilot study’s results support performing a larger study to determine if the pharmacist’s recommendation not only improves patient care by lowering A1C levels but if it also helps improve medical resident’s understanding and use of medications for diabetes.

Write to recover: The impact of group led creative writing on behavioral health outcomes in cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11536-11536
Author(s):  
Darya Nesterova ◽  
Junjia Zhu ◽  
Courtney Kramer ◽  
Monali K. Vasekar ◽  
Jolene Collins ◽  
...  
Keyword(s):  
Creative Writing ◽  
Cancer Patients ◽  
Statistical Significance ◽  
Mental Wellbeing ◽  
Cancer Type ◽  
Depression And Anxiety ◽  
Emotional Wellbeing ◽  
Post Intervention ◽  
Significance Level ◽  
The Impact

11536 Background: The diagnosis of cancer can adversely affect mental wellbeing. In addition to treating cancer, the emotional wellbeing of patients must simultaneously be addressed. A previous pilot exploring the feasibility of creative writing workshop (CWW) in cancer patients showed apositive effect on patients’ mental health. Methods: To longitudinally evaluate the efficacy of CWW on mood, we conducted a phase II study with cancer patients (any stage, any cancer type); randomized 2:1 to CWW vs. active control (AC). Patients in the CWW arm attended at least 4, 1.5-hour bi-monthly CWW x 8 wks, whereas AC patients completed independent writing at home with the help of a book (bi-monthly x 8wks). We used validated tools, [Emotional Thermometer Scales (ETS), PHQ-9, GAD-7] to assess changes in overall mood, depression, and anxiety. Primary end point: a) ETS scores before and after intervention b) Changes in depression and anxiety based on PHQ-9 and GAD-7 scores. We present results from ETS scores. Descriptive statistics were generated for these quantitative scales measured in each group, pre and post intervention. Comparisons between groups (gp) were made using Wilcoxon Rank-sum tests. All tests were two sided and the statistical significance level used was 0.05. Results: Amongst evaluable patients, N of 50 (demographics in table below), twenty-six patients in the CWW gp attended at least one class and 19 attended at least 4 classes. Patients in CWW showed significant mood improvement vs. AC when comparing the final overall ETS (p=0.0063). Three of the five sub-scale ETS scores were significantly lower for the CWW vs. AC gp: anxiety (p=0.0027), depression (p=0.0009), and anger (p=0.0027). Conclusions: Group led CWW have a positive effect on mood. Our results suggest potential therapeutic benefit of this intervention on the emotional wellbeing of cancer patients. Larger studies are needed to evaluate the effect of CWW in cancer patients. Clinical trial information: NCT03536702. [Table: see text]

The Effects of Multi-Slice Helical Computed Tomography and Phlebography on Edema Regression Nursing of Lower Limbs Varicosis

2020 ◽  
Vol 10 (9) ◽  
pp. 2124-2129
Author(s):  
Jinmei Zu ◽  
Ruyue Chen ◽  
Jia Kang ◽  
Yaru Han ◽  
Gaixin Zhang
Keyword(s):  
Computed Tomography ◽  
Lower Limb ◽  
Statistical Significance ◽  
Lower Limbs ◽  
Helical Computed Tomography ◽  
High Ligation ◽  
Gabor Filtering ◽  
Operation Rate ◽  
Group A ◽  
Group B

Objective: To explore the effects of multi-slice helical computed tomography (MSCT) and phlebography on edema regression nursing of lower limbs varicosis, and to analyze the values of MSCT and phlebography on the diagnosis and treatment of lower limb varicosis. Methods: A total of 193 patients with lower limb varicosis treated in the Vascular Surgery Department were included as the research objects. According to different examination methods, the included patients were divided into the MSCT group, and the MSCT combined with the phlebography group, Then, patients in both groups received joint treatment of high ligation and varicectomy. The Gabor filtering-based algorithm and the Mean-Variance Efficient Frontier (MVEF) algorithm were used to smoothen the obtained images. Also, the operation rates and contradiction compositions of patients in both groups were analyzed. Patients who received surgical treatment were followed up for three months to one year; whether the deep vein thrombosis (DVT) occurred in them were observed, as well as the edema regression. Results: As for gender, grading, disease history, duration of disease, and onset age of both groups, no statistical significance was found (P > 0.05). Compared to group A, the positive detection rate of postoperative DVT was lower in group B, so did the operation rate. In group A, 32 cases of edema regressed significantly, and the disease condition was relieved. In group B, 35 cases of edema were regressed. Conclusion: Compared with MSCT, phlebography had a higher screening rate for indications of lower limb varicosis, which could effectively reduce the probability of DVT after operations and relieve the symptoms of edema in patients. In addition, although the sensitivity of MSCT was relatively low, it could be used for the primary screening diagnosis of lower limb varicosis.

Physical activity and prenatal depression: going beyond statistical significance by assessing the impact of reliable and clinical significant change

2020 ◽  
pp. 1-6
Author(s):  
Marina Vargas-Terrones ◽  
Taniya S. Nagpal ◽  
Maria Perales ◽  
Harry Prapavessis ◽  
Michelle F. Mottola ◽  
...  
Keyword(s):  
At Risk ◽  
Exercise Intervention ◽  
Statistical Significance ◽  
Intervention Group ◽  
Prenatal Depression ◽  
Control Group ◽  
Post Intervention ◽  
Point Change ◽  
Significant Change ◽  
The Impact

Abstract Background Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistical significance and reliable and clinically significant change criteria. Methods This study is a secondary analysis of two randomized controlled trials that followed the same exercise protocol. Pregnant women were allocated to an exercise intervention group (IG) or control group (CG). All participants completed the Center for Epidemiological Depression (CES-D) scale at gestational week 9–16 and 36–38. Women with a baseline score ⩾16 were included. A clinically reliable cut-off was calculated as a 7-point change in scores from pre- to post-intervention. Results Thirty-six women in the IG and 25 women in the CG scored ⩾16 on the CES-D at baseline. At week 36–38 the IG had a statistically significant lower CES-D score (14.4 ± 8.6) than the CG (19.4 ± 11.1; p < 0.05). Twenty-two women in the IG (61%) had a clinically reliable decrease in their post-intervention score compared to eight women in the CG (32%; p < 0.05). Among the women who met the reliable change criteria, 18 (81%) in the IG and 7 (88%) in the CG had a score <16 post-intervention, with no difference between groups (p > 0.05). Conclusions A structured exercise program might be a useful treatment option for women at risk for prenatal depression.

Sign in / Sign up

Export Citation Format

Share Document