Comparative effects of EMG-driven robot-assisted therapy versus task-oriented training on motor and daily function in patients with stroke: a randomized cross-over trial

Background Robot-assisted hand training has shown positive effects on promoting neuromuscular control. Since both robot-assisted therapy and task-oriented training are often used in post-stroke rehabilitation, we raised the question of whether two interventions engender differential effects in different domains. Methods The study was conducted using a randomized, two-period crossover design. Twenty-four chronic stroke survivors received a 12-session robot-assisted intervention followed by a 12-session task-oriented intervention or vice versa. A 1-month washout period between each intervention was implemented. Outcome measures were evaluated before the intervention, after the first 12-session intervention, and after the second 12-session intervention. Clinical assessments included Fugl-Meyer Assessment for Upper Extremity, Wolf Motor Function Test, Action Research Arm Test and Motor Activity Log. Results Our findings suggested that EMG-driven robot-assisted therapy was as effective as task-oriented training in terms of improving upper limbs functional performance in activity domain, and robot-assisted therapy was more effective in improving movement duration during functional tasks. Task-oriented training showed better improvement in body function domain and activity and participation domain, especially in improving spontaneous use of affected arm during daily activities. Conclusions Both intervention protocol had their own advantages in different domains, and robot-assisted therapy may save manpower and be considered as an alternative intervention to task-oriented training. Combining the two approaches could yield results greater than either alone, which awaits further study. Trial registration: ClinicalTrials.gov Identifier: NCT03624153. Registered on 9th August 2018, https://clinicaltrials.gov/ct2/show/NCT03624153.

The Impact of Mouthwash on the Oropharyngeal Microbiota of Men Who Have Sex with Men: a Substudy of the OMEGA Trial

Given the role of the oral microbiota in human health, it is important to understand if and how external factors influence its composition. Mouthwash use is common in some populations, and the use of antiseptic mouthwash has been proposed as an alternative intervention to prevent gonorrhea transmission.

Neuro-Linguistic Programming, Positive Psychology & VR in Special Education

In the era of rapid change, special education is in the quest to ‘drive up standards’ with alternative intervention strategies ensuring optimal outcomes for parents, teachers and learners. Automatic thoughts, negative beliefs and implicit bias demotivate, disrupt students’ behavior, and lower the quality of learning outcomes. Neuro-linguistic programming (NLP) is a psychological approach that employs appropriate techniques to help individuals deal with their dysfunctional schemas. The present paper aims at reviewing the research studies regarding the effectiveness of neurolinguistic programming (NLP) in challenging situations as those that people with disabilities face. In addition, we will co-examine the possible applications of NLP on virtual reality (VR) environments. The findings of this review support the idea that neuro-linguistic programming provides influencing strategies for students with special educational needs to be rapidly engaged in those states of mind that eliminate implicit bias and promote positive behaviors and academic achievement. It was found that VR is in line with NLP methodology contributing to unintended bias reduction, cultivating users’ ability to change perspective with flexibility, expecting a positive future and perceiving themselves more realistically with less symptoms of depression. This study takes the view of a new pedagogy in Special Education that integrates the overlapping areas of neurolinguistic programming, positive and social psychology and recognizes their role in developing brain rewiring and sub-conscious training techniques -even in virtual environments-.

Literature Review : Penerapan Teknik Pernafasan Buteyko Terhadap Penurunan Frekuensi Kekambuhan Asma Pada Pasien Asma Bronkhial

One of the non-pharmacological therapies to reduce the frequency of asthma recurrence is the Buteyko breathing technique. The study aimed to describe the application of the Buteyko breating technique in asthmatic patients. The study applied Literature Review design. Three articles were obtained from google scolar website, with the keywords “Bronchial Asthma,” “Asthma Recurrence,” and “Buteyko Breathing Technique”. All these three articles were fulltext articles, published in 2014-2021. The result of the Literature Review of the two articles, based on the average value bevore the intervention was 2,74 and after the intervention was 1,66 and one of the articles did not explain the avarge value. The study approved that Buteyko Breathing Technique can be an alternative intervention to reduce the frequency of asthmatic patients. Furthermore, healthcare providers were suggest to educate their patients to do so.Keywords: Asthma Recurrence, Asthmatic Patient, Buteyko Breathing Technique AbstrakSalah satu terapi non farmakologis untuk menurunkan frekuensi kekambuhan Asma adalah teknik pernafasan Buteyko. Penelitian ini bertujuan untuk menggambarkan penerapan teknik pernafasan Buteyko pada pasien Asma berdasarkan Literatur Review. Desain Karya Tulis Ilmiah berupa Literatur Review dengan jumlah artikel tiga yang diambil dari laman jurnal google scolar dengan kata kunci “Asma Bronkhial,” “Kekambuhan Asma,” dan “Teknik Pernafasan Buteyko” berupa artikel fulltex, terbit tahun 2014-2021. Hasil Literatur Review dari kedua artikel berdasarkan nilai rata-rata sebelum intervensi yaitu 2,74 dan sesudah intervensi menjadi 1,66 dan salah satu artikel tidak menjelaskan nilai rata-rata. Kesimpulannya adalah teknik pernafasan Buteyko dapat menurunkan frekuensi kekambuhan asma pada pasien asma. Saran bagi tenaga kesehatan hendaknya mengedukasi tentang teknik pernafasan Buteyko sebagai alternatif untuk menurunkan frekuensi kekambuhan asma pada pasien asma.Kata kunci: Asma Bronkhial, Kekambuhan Asma, dan Teknik Pernafasan Buteyko

Penerapan Terapi Bermain Plastisin Terhadap Perkembangan Motorik Halus Pada Anak Usia Prasekolah Dengan Resiko Gangguan Perkembangan

Psychomotor skills are children’s ability to use small muscles and coordination between eyes and hands. Thus, children are able to doing their activities independently. One of the media used to improve the psychomotor skills of preschool-aged children is using plasticine. The purpose of this study was to describe the application of plasticine play therapy in improving psychomotor skills in preschool-aged children. The descriptive study design was used in this case study. There are two preschool-aged children who are at risk of developmental disorders join in this study. The developmental pre-screening questionnaire (KPSP) was used to assess the psychomotor skills. The results show that before the intervention the KPSP value of both respondents was 5. After the intervention the KPSP value was increased to 10 and 12. Thus, plasticine play therapy can improve the psychomotor skills among preschool-aged children who are at risk of developmental disorders. Furthermore, nurses suggested to implement plasticine play therapy as an alternative intervention to improve psychomotor skills in preschool-aged children.Keywords: psychomotor skills; Preschool-aged children; plasticine. AbstrakMotorik halus merupakan kemampuan anak mengunakan otot-otot kecil serta koordinasi antara mata dan tangan, sehingga anak mampu melakukan aktivitas mandiri dengan baik. Salah satu media yang digunakan untuk meningkatkan motorik halus anak usia prasekolah adalah menggunakan plastisin. Tujuan penulisan ini untuk menggambarkan penerapan terapi bermain plastisin dalam meningkatkan motorik halus pada anak usia prasekolah. Metode yang digunakan dalam studi kasus ini adalah penelitian deskriptif dengan subyek dua pasien anak usia prasekolah yang mengalami resiko gangguan perkembangan. Alat ukur yang digunakan adalah lembar observasi yang mengacu pada kuesioner pra skrining perkembangan (KPSP). Hasil menunjukan sebelum intervensi nilai observasi kedua responden 5. Setelah intervensi nilai observasi kasus satu meningkat menjadi 10, sedangkan kasus dua meningkat menjadi 12. Kesimpulannya adalah penerapan terapi bermain plastisin dapat meningkatkan motorik halus anak usia prasekolah yang mengalami resiko gangguan perkembangan. Saran bagi perawat menjadikan terapi bermain plastisin sebagai salah satu alternatif tindakan untuk meningkatkan motorik halus pada anak usia prasekolah.Kata kunci : Motorik halus; Anak usia prasekolah; plastisin.

The preparation phase in the multiphase optimization strategy (MOST): a systematic review and introduction of a reporting checklist

Multicomponent behavioral interventions developed using the multiphase optimization strategy (MOST) framework offer important advantages over alternative intervention development models by focusing on outcomes within constraints relevant for effective dissemination. MOST consists of three phases: preparation, optimization, and evaluation. The preparation phase is critical to establishing the foundation for the optimization and evaluation phases; thus, detailed reporting is critical to enhancing rigor and reproducibility. A systematic review of published research using the MOST framework was conducted. A structured framework was used to describe and summarize the use of MOST terminology (i.e., preparation phase and optimization objective) and the presentation of preparation work, the conceptual model, and the optimization. Fifty-eight articles were reviewed and the majority focused on either describing the methodology or presenting results of an optimization trial (n = 38, 66%). Although almost all articles identified intervention components (96%), there was considerable variability in the degree to which authors fully described other elements of MOST. In particular, there was less consistency in use of MOST terminology. Reporting on the MOST preparation phase is varied, and there is a need for increased focus on explicit articulation of key design elements and rationale of the preparation phase. The proposed checklist for reporting MOST studies would significantly advance the use of this emerging methodology and improve implementation and dissemination of MOST. Accurate reporting is essential to reproducibility and rigor of scientific trials as it ensures future research fully understands not only the methodology, but the rationale for intervention and optimization decisions.

The Effectiveness of Cabbage Leaf Compress and the Education of Lactation Management in Reducing Breast Engorgement in Postpartum

BACKGROUND: Breast engorgement is a common problem of breastfeeding. The combination of nursing interventions is expected to prevent and reduce breast engorgement promptly. AIM: This study aims to determine the effectiveness of cabbage leaf compress and education on lactation management for reducing breast engorgement in postpartum. METHODS: This study was a quasi-experimental study with a non-equivalent control group design. The sample was 60 postpartum women (n = 30 the intervention group and n = 30 the control group) selected by purposive sampling. The instrument was the Breast Engorgement Scale. The intervention included giving compress on women’s breast using the cabbage leaf and educating them about lactation management, while the control group was given treatment according to hospital standard procedures. The study was conducted in a national referral hospital for West Java Province areas, Indonesia. Data were analyzed using the Wilcoxon sign-rank test and the effectiveness of intervention tested using the NGain score test. RESULTS: There was a difference in breast engorgement scale before intervention with median value ± min max (3.00 ± 2-6) and after median ± min max (2.00 ± 1-2), while in the control group the breast engorgement scale before treatment showed the median was ± min-max (2.00 ± 2-5) and after treatment, was ± min-max (2.00 ± 1-5). The effectiveness of intervention was 77.56%. CONCLUSIONS: The combination interventions of cabbage leaf compress and lactation management education were effective in reducing the breast engorgement in postpartum. This intervention can be used as an alternative intervention to solve the breast engorgement problem in postpartum women, especially for a developing country like Indonesia, because the cabbage leaf is cheap and easy to get in the traditional market. Further research is expected to conduct research on a qualitative design to understand women’s experience after interventions and the possibility to apply this intervention at home.

The movement-to-music (M2M) study: study protocol for a randomized controlled efficacy trial examining a rhythmic teleexercise intervention for people with physical disabilities

Background People with physical disabilities need exercise routines that are enjoyable, readily available in the home, adapted to their functional level, and eliminate common barriers to exercise participation related to transportation and time commitment. The purpose of the movement-to-music (M2M) study is to address these issues by establishing a remotely delivered, rhythmic exercise program for people with physical disabilities. Methods The study is a two-arm randomized controlled efficacy trial examining a 12-week remotely delivered M2M intervention (eM2M) in 108 people with physical disabilities. The primary outcomes are changes in cardiorespiratory fitness and muscle strength at post 12-week intervention. Discussion The eM2M study will enhance our understanding of an alternative intervention design and delivery mode that removes common barriers to exercise participation experienced by people with physical disabilities. The eM2M intervention may be an alternative option for people with physical disabilities to obtain regular exercise, especially during a pandemic when exercising in indoor facilities may be problematic. Trial registration ClinicalTrials.gov NCT03797378. Registered on January 9, 2019, with the trial name “Movement-to-Music: Lakeshore Examination of Activity, Disability, and Exercise Response Study (M2M LEADERS)”.

Using Neurofeedback to Restore Inter-Hemispheric Imbalance: A Study Protocol for Adults With Dyslexia

Neurofunctional models of developmental dyslexia (DD) point out disruption of the left-lateralized reading network. In individuals with DD, the left temporo-parietal (TP) regions are underactivated during reading tasks and a dysfunctional activation of the contralateral regions is reported. After a successful reading intervention, left TP lateralization was found to be increased in children with DD. Previous studies measured the effect of modulating the excitability of the left TP cortex using non-invasive brain stimulation (NIBS) in individuals with reading difficulties, showing significant reading improvements. NIBS exclusion criteria and safety guidelines may limit its application in settings without medical supervision and in younger populations. Neurofeedback (NF) training could be an alternative intervention method for modulating the inter-hemispheric balance of the temporal–parietal regions in DD. To date, the effect of NF on reading has been scarcely investigated. Few protocols increasing beta activity in underactivated areas showed improved reading outcomes. However, none of the previous studies designed the NF intervention based on a neurofunctional model of DD. We aim to propose a study protocol for testing the efficacy of a NF training specifically designed for inducing a functional hemispheric imbalance of the tempo-parietal regions in adults with DD. A randomized clinical trial aimed at comparing two experimental conditions is described: (a) Enhancing left beta/theta power ratio NF training in combination with reducing right beta/theta power ratio NF training and (b) sham NF training.Clinical Trial Registration:www.ClinicalTrials.gov, identifier [NCT04989088].

An Integrated Approach to Improve Seismic and Energetic Behaviour of RC Framed Buildings Using Timber Panels

In the present paper, an integrated intervention system applicable to concrete-framed buildings is presented. The purpose of the intervention is to improve both the seismic and the energetic behaviour of such buildings using cross-laminated timber (CLT) panels. Two alternative intervention configurations with different levels of invasiveness are described. Considering a double-wythe masonry-infilled frame, the most invasive configuration consists in the replacement of the external masonry wythe with the CLT panel, while the least invasive configuration consists in the arrangement of the CLT panel from the outside without removing the wythes. The technical details and implementation procedures were studied, considering functionality and disturbance to occupants. An isolated one-storey-one-bay frame was used as a reference for the seismic and thermal analyses. Subsequently, the two intervention configurations were applied to a case-study building by identifying two alternative intervention strategies. The obtained results showed that the proposed integrated intervention approach can significantly reduce both the seismic vulnerability and the energy consumption of concrete buildings.