Background: The Home Hearing Test (HHT) is an automated pure-tone threshold test that obtains an air conduction audiogram at five test frequencies. It was developed to provide increased access to hearing testing and support home telehealth programs. Purpose: Test and retest thresholds for 1000-Hz stimuli were analyzed to determine intrasubject variability from two independent data sets. Research Design: Prospective, repeated measures. Study Sample: In the Veterans Affairs (VA) study, results from 26 subjects 44 to 88 years of age (mean = 65) recruited from the Nashville VA audiology clinic were analyzed. Subjects were required to have a Windows PC in the home and were self-reported to be comfortable with using computers. Two subjects had normal hearing, and 24 had hearing losses of various severities and configurations. The National Center for Rehabilitative Auditory Research (NCRAR) sample included 100 subjects (68 males; 32 females) with a complaint of hearing difficulty recruited from the local community and Veteran population. Subjects ranged in age from 32 to 87 years (mean = 63.7 years). They were tested in a quiet room at the NCRAR. Data Collection and Analysis: Subjects in the VA study were provided kits for installing HHT on their home computers. HHT was installed on a computer at NCRAR to test subjects in the NCRAR study. HHT obtains a five-frequency air conduction audiogram with a retest of 1000 Hz in both ears. Only the 1000-Hz test–retest results are analyzed in this report. Six statistical measures of test–retest variability are reported. Results: Test and retest thresholds were highly correlated in both studies (r ≥ 0.96). Test–retest differences were within ±5 dB ≥92% of the time in the two studies. Standard deviations of absolute test–retest difference were ≤3.5 dB in the two studies. Conclusions: Intrasubject variability is comparable to that obtained with manual testing by audiologists in sound-treated test rooms. ACKNOWLEDGMENTS: The authors thank Drs. Josephine Helmbrecht, Rachel Tomasek, and Jay Vachhani for their valuable assistance. R.H.M., M.C.K., and G.L.S. have commercial interests in the Home Hearing Test. This work was supported by contract nos. VA-14-0005253 and VA118-12-C-0029 from the U.S. Department of Veterans Affairs and grant nos. R33DC011769 and 4R33DC011769 from the National Institute on Deafness and Other Communication Disorders. The Home Hearing Test was developed in response to the recommendations from the Workshop on Accessible and Affordable Hearing Health Care for Adults with Mild to Moderate Hearing Loss, Bethesda, Maryland, August 25–27, 2009, sponsored by the National Institute on Deafness and Other Communications Disorders. See Donahue et al. (2010) for a report of the workshop. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs. Address for correspondence: Robert H. Margolis, Audiology Incorporated, 4410 Dellwood Street, Arden Hills, MN 55112, USA. E-mail: rhmargo001@gmail.com Received August 22, 2017; accepted November 29, 2017. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Σάββατο 20 Ιανουαρίου 2018
Home Hearing Test: Within-Subjects Threshold Variability
Background: The Home Hearing Test (HHT) is an automated pure-tone threshold test that obtains an air conduction audiogram at five test frequencies. It was developed to provide increased access to hearing testing and support home telehealth programs. Purpose: Test and retest thresholds for 1000-Hz stimuli were analyzed to determine intrasubject variability from two independent data sets. Research Design: Prospective, repeated measures. Study Sample: In the Veterans Affairs (VA) study, results from 26 subjects 44 to 88 years of age (mean = 65) recruited from the Nashville VA audiology clinic were analyzed. Subjects were required to have a Windows PC in the home and were self-reported to be comfortable with using computers. Two subjects had normal hearing, and 24 had hearing losses of various severities and configurations. The National Center for Rehabilitative Auditory Research (NCRAR) sample included 100 subjects (68 males; 32 females) with a complaint of hearing difficulty recruited from the local community and Veteran population. Subjects ranged in age from 32 to 87 years (mean = 63.7 years). They were tested in a quiet room at the NCRAR. Data Collection and Analysis: Subjects in the VA study were provided kits for installing HHT on their home computers. HHT was installed on a computer at NCRAR to test subjects in the NCRAR study. HHT obtains a five-frequency air conduction audiogram with a retest of 1000 Hz in both ears. Only the 1000-Hz test–retest results are analyzed in this report. Six statistical measures of test–retest variability are reported. Results: Test and retest thresholds were highly correlated in both studies (r ≥ 0.96). Test–retest differences were within ±5 dB ≥92% of the time in the two studies. Standard deviations of absolute test–retest difference were ≤3.5 dB in the two studies. Conclusions: Intrasubject variability is comparable to that obtained with manual testing by audiologists in sound-treated test rooms. ACKNOWLEDGMENTS: The authors thank Drs. Josephine Helmbrecht, Rachel Tomasek, and Jay Vachhani for their valuable assistance. R.H.M., M.C.K., and G.L.S. have commercial interests in the Home Hearing Test. This work was supported by contract nos. VA-14-0005253 and VA118-12-C-0029 from the U.S. Department of Veterans Affairs and grant nos. R33DC011769 and 4R33DC011769 from the National Institute on Deafness and Other Communication Disorders. The Home Hearing Test was developed in response to the recommendations from the Workshop on Accessible and Affordable Hearing Health Care for Adults with Mild to Moderate Hearing Loss, Bethesda, Maryland, August 25–27, 2009, sponsored by the National Institute on Deafness and Other Communications Disorders. See Donahue et al. (2010) for a report of the workshop. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs. Address for correspondence: Robert H. Margolis, Audiology Incorporated, 4410 Dellwood Street, Arden Hills, MN 55112, USA. E-mail: rhmargo001@gmail.com Received August 22, 2017; accepted November 29, 2017. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Home Hearing Test: Within-Subjects Threshold Variability
Background: The Home Hearing Test (HHT) is an automated pure-tone threshold test that obtains an air conduction audiogram at five test frequencies. It was developed to provide increased access to hearing testing and support home telehealth programs. Purpose: Test and retest thresholds for 1000-Hz stimuli were analyzed to determine intrasubject variability from two independent data sets. Research Design: Prospective, repeated measures. Study Sample: In the Veterans Affairs (VA) study, results from 26 subjects 44 to 88 years of age (mean = 65) recruited from the Nashville VA audiology clinic were analyzed. Subjects were required to have a Windows PC in the home and were self-reported to be comfortable with using computers. Two subjects had normal hearing, and 24 had hearing losses of various severities and configurations. The National Center for Rehabilitative Auditory Research (NCRAR) sample included 100 subjects (68 males; 32 females) with a complaint of hearing difficulty recruited from the local community and Veteran population. Subjects ranged in age from 32 to 87 years (mean = 63.7 years). They were tested in a quiet room at the NCRAR. Data Collection and Analysis: Subjects in the VA study were provided kits for installing HHT on their home computers. HHT was installed on a computer at NCRAR to test subjects in the NCRAR study. HHT obtains a five-frequency air conduction audiogram with a retest of 1000 Hz in both ears. Only the 1000-Hz test–retest results are analyzed in this report. Six statistical measures of test–retest variability are reported. Results: Test and retest thresholds were highly correlated in both studies (r ≥ 0.96). Test–retest differences were within ±5 dB ≥92% of the time in the two studies. Standard deviations of absolute test–retest difference were ≤3.5 dB in the two studies. Conclusions: Intrasubject variability is comparable to that obtained with manual testing by audiologists in sound-treated test rooms. ACKNOWLEDGMENTS: The authors thank Drs. Josephine Helmbrecht, Rachel Tomasek, and Jay Vachhani for their valuable assistance. R.H.M., M.C.K., and G.L.S. have commercial interests in the Home Hearing Test. This work was supported by contract nos. VA-14-0005253 and VA118-12-C-0029 from the U.S. Department of Veterans Affairs and grant nos. R33DC011769 and 4R33DC011769 from the National Institute on Deafness and Other Communication Disorders. The Home Hearing Test was developed in response to the recommendations from the Workshop on Accessible and Affordable Hearing Health Care for Adults with Mild to Moderate Hearing Loss, Bethesda, Maryland, August 25–27, 2009, sponsored by the National Institute on Deafness and Other Communications Disorders. See Donahue et al. (2010) for a report of the workshop. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs. Address for correspondence: Robert H. Margolis, Audiology Incorporated, 4410 Dellwood Street, Arden Hills, MN 55112, USA. E-mail: rhmargo001@gmail.com Received August 22, 2017; accepted November 29, 2017. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Psychometric properties of outcome measures evaluating decline in gait in cerebellar ataxia: A systematic review
Source:Gait & Posture, Volume 61
Author(s): Sarah C. Milne, Anna Murphy, Nellie Georgiou-Karistianis, Eppie M. Yiu, Martin B. Delatycki, Louise A. Corben
Cerebellar ataxia often results in impairment in ambulation secondary to gait pattern dysfunction and compensatory gait adjustments. Pharmaceutical and therapy-based interventions with potential benefit for gait in ataxia are starting to emerge, however evaluation of such interventions is hampered by the lack of outcome measures that are responsive, valid and reliable for measurement of gait decline in cerebellar ataxia. This systematic review aimed for the first time to evaluate the psychometric properties of gait and walking outcomes applicable to individuals with cerebellar ataxia. Only studies evaluating straight walking were included. A comprehensive search of three databases (MEDLINE, CINAHL and EMBASE) identified 53 studies meeting inclusion criteria. Forty-nine were rated as ‘poor’ as assessed by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The primary objective of most studies was to explore changes in gait related to ataxia, rather than to examine psychometric properties of outcomes. This resulted in methodologies not specific for psychometric assessment. Thirty-nine studies examined validity, 11 examined responsiveness and 12 measured reliability. Review of the data identified double and single support and swing percentage of the gait cycle, velocity, step length and the Scale for Assessment and Rating of Ataxia (SARA) gait item as the most valid and responsive measures of gait in cerebellar ataxia. However, further evaluation to establish their reliability and applicability for use in clinical trials is clearly warranted. We recommend that inter-session reliability of gait outcomes should be evaluated to ensure changes are reflective of intervention effectiveness in cerebellar ataxia.
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Temporal-spatial gait parameter models of very slow walking
Source:Gait & Posture, Volume 61
Author(s): Andrew J.J. Smith, Edward D. Lemaire
This study assessed the relationship between walking speed and common temporal-spatial stride-parameters to determine if a change in gait strategy occurs at extremely slow walking speeds. Stride-parameter models that represent slow walking can act as a reference for lower extremity exoskeleton and powered orthosis controls since these devices typically operate at walking speeds less than 0.4 m/s. Full-body motion capture data were collected from 30 health adults while walking on a self-paced treadmill, within a CAREN-Extended virtual reality environment. Kinematic data were collected for 0.2–0.8 m/s, and self-selected walking speed. Eight temporal stride-parameters were determined and their relationship to walking speed was assessed using linear and quadratic regression. Stride-length, step-length, and step-frequency were linearly related to walking speed, even at speeds below 0.4 m/s. An inflection point at 0.5 m/s was found for stride-time, step-time, stance-time, and double support time. Equations were defined for each stride-parameter, with equation outputs producing correlations greater than 0.91 with the test data. This inflection point suggests a change in gait strategy at very slow walking speeds favouring greater ground contact time.
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Reported balance confidence and movement reinvestment of younger knee replacement patients are more like younger healthy individuals, than older patients
Source:Gait & Posture, Volume 61
Author(s): Brian D. Street, Allan Adkin, William Gage
This study focused on differences between the rapidly growing younger (<65 years old) and older (>65 years old) total knee replacement (TKR) patients for measures of balance confidence, movement reinvestment, and functional mobility. Fifty-nine participants, including twenty-nine primary unilateral TKR patients (six months post-TKR) formed the four experimental groups: 1) Younger TKR Patient (YP), 2) Younger Control (YC), 3) Older TKR Patient (OP), and 4) Older Control (OC). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Oxford Knee Score (OKS), Activities-specific Balance Confidence scale (ABC), the Movement-Specific Reinvestment Scale (MSRS), and the Timed Up and Go (TUG) test were measured. The YP group reported a significantly lower WOMAC score (p < 0.001), and higher perceived knee joint function (p = 0.001), compared to the OP group. The YP group also reported significantly higher balance confidence (p < 0.001) and less movement reinvestment (p = 0.001) than the OP group. TUG durations revealed that the YP group had significantly higher functional mobility compared to the OP group (p = 0.001). The YP group did not differ from the YC group across any of these measures (p > 0.05). These results identify a clear distinction between younger and older TKR patients for fall risk and TKR outcome, which argues that age should be a factor clinicians take into account when addressing the management and care of individuals recovering from TKR.
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Distal upper limb kinematics during functional everyday tasks
Source:Gait & Posture, Volume 61
Author(s): Ben Stansfield, Scott Rooney, Lisa Brown, Matthew Kay, Lisa Spoettl, Shivaramkumar Shanmugam
Quantitative characterisation of upper limb motion allows the evaluation of the effect of pathology on functional task performance, potentially directing rehabilitation strategies. Movement patterns of the distal upper limb in healthy adults during functional tasks have not been extensively characterised. During five loaded functional tasks (drinking from a glass, pouring from a kettle, turning a handle, lifting a bag to a shelf, turning a key) the movement patterns were characterised using three-dimensional motion analysis with a minimal marker set in 16 healthy adults (10 M,6F, 27 (IQR:25–43)years). Joint angles reported include flexion/extension at the elbow and wrist, forearm supination/pronation and digits 2–5 metacarpophalangeal (MCP) joint flexion/extension. Additionally for the thumb the angle between the metacarpal of the thumb and the 2nd digit (Thumb base), the thumb MCP (Thumb MCP) and interphalangeal (Thumb IP) joint angles are presented. Durations of activities performed at self-selected comfortable speeds (3.36 (IQR:3.07,3.66)s turning a key to 6.20 (IQR:5.44,6.38)s drinking from a glass) are reported. The maximum joint angles used (median of participants’ maxima) were 141° of elbow flexion, 116° forearm supination, 36° wrist extension, 56° Thumb base, 14° Thumb MCP flexion, 18° Thumb IP flexion, 85° MCP2-5 flexion. The tasks of drinking from a glass, lifting a bag to a shelf and turning a key appeared to have the least variation in performance, suggesting that these activities are better suited to be selected as standardized tasks for assessing the impact of pathology on movement than pouring from a kettle and turning a handle.
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Psychometric properties of outcome measures evaluating decline in gait in cerebellar ataxia: A systematic review
Source:Gait & Posture, Volume 61
Author(s): Sarah C. Milne, Anna Murphy, Nellie Georgiou-Karistianis, Eppie M. Yiu, Martin B. Delatycki, Louise A. Corben
Cerebellar ataxia often results in impairment in ambulation secondary to gait pattern dysfunction and compensatory gait adjustments. Pharmaceutical and therapy-based interventions with potential benefit for gait in ataxia are starting to emerge, however evaluation of such interventions is hampered by the lack of outcome measures that are responsive, valid and reliable for measurement of gait decline in cerebellar ataxia. This systematic review aimed for the first time to evaluate the psychometric properties of gait and walking outcomes applicable to individuals with cerebellar ataxia. Only studies evaluating straight walking were included. A comprehensive search of three databases (MEDLINE, CINAHL and EMBASE) identified 53 studies meeting inclusion criteria. Forty-nine were rated as ‘poor’ as assessed by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The primary objective of most studies was to explore changes in gait related to ataxia, rather than to examine psychometric properties of outcomes. This resulted in methodologies not specific for psychometric assessment. Thirty-nine studies examined validity, 11 examined responsiveness and 12 measured reliability. Review of the data identified double and single support and swing percentage of the gait cycle, velocity, step length and the Scale for Assessment and Rating of Ataxia (SARA) gait item as the most valid and responsive measures of gait in cerebellar ataxia. However, further evaluation to establish their reliability and applicability for use in clinical trials is clearly warranted. We recommend that inter-session reliability of gait outcomes should be evaluated to ensure changes are reflective of intervention effectiveness in cerebellar ataxia.
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Temporal-spatial gait parameter models of very slow walking
Source:Gait & Posture, Volume 61
Author(s): Andrew J.J. Smith, Edward D. Lemaire
This study assessed the relationship between walking speed and common temporal-spatial stride-parameters to determine if a change in gait strategy occurs at extremely slow walking speeds. Stride-parameter models that represent slow walking can act as a reference for lower extremity exoskeleton and powered orthosis controls since these devices typically operate at walking speeds less than 0.4 m/s. Full-body motion capture data were collected from 30 health adults while walking on a self-paced treadmill, within a CAREN-Extended virtual reality environment. Kinematic data were collected for 0.2–0.8 m/s, and self-selected walking speed. Eight temporal stride-parameters were determined and their relationship to walking speed was assessed using linear and quadratic regression. Stride-length, step-length, and step-frequency were linearly related to walking speed, even at speeds below 0.4 m/s. An inflection point at 0.5 m/s was found for stride-time, step-time, stance-time, and double support time. Equations were defined for each stride-parameter, with equation outputs producing correlations greater than 0.91 with the test data. This inflection point suggests a change in gait strategy at very slow walking speeds favouring greater ground contact time.
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Reported balance confidence and movement reinvestment of younger knee replacement patients are more like younger healthy individuals, than older patients
Source:Gait & Posture, Volume 61
Author(s): Brian D. Street, Allan Adkin, William Gage
This study focused on differences between the rapidly growing younger (<65 years old) and older (>65 years old) total knee replacement (TKR) patients for measures of balance confidence, movement reinvestment, and functional mobility. Fifty-nine participants, including twenty-nine primary unilateral TKR patients (six months post-TKR) formed the four experimental groups: 1) Younger TKR Patient (YP), 2) Younger Control (YC), 3) Older TKR Patient (OP), and 4) Older Control (OC). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Oxford Knee Score (OKS), Activities-specific Balance Confidence scale (ABC), the Movement-Specific Reinvestment Scale (MSRS), and the Timed Up and Go (TUG) test were measured. The YP group reported a significantly lower WOMAC score (p < 0.001), and higher perceived knee joint function (p = 0.001), compared to the OP group. The YP group also reported significantly higher balance confidence (p < 0.001) and less movement reinvestment (p = 0.001) than the OP group. TUG durations revealed that the YP group had significantly higher functional mobility compared to the OP group (p = 0.001). The YP group did not differ from the YC group across any of these measures (p > 0.05). These results identify a clear distinction between younger and older TKR patients for fall risk and TKR outcome, which argues that age should be a factor clinicians take into account when addressing the management and care of individuals recovering from TKR.
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Distal upper limb kinematics during functional everyday tasks
Source:Gait & Posture, Volume 61
Author(s): Ben Stansfield, Scott Rooney, Lisa Brown, Matthew Kay, Lisa Spoettl, Shivaramkumar Shanmugam
Quantitative characterisation of upper limb motion allows the evaluation of the effect of pathology on functional task performance, potentially directing rehabilitation strategies. Movement patterns of the distal upper limb in healthy adults during functional tasks have not been extensively characterised. During five loaded functional tasks (drinking from a glass, pouring from a kettle, turning a handle, lifting a bag to a shelf, turning a key) the movement patterns were characterised using three-dimensional motion analysis with a minimal marker set in 16 healthy adults (10 M,6F, 27 (IQR:25–43)years). Joint angles reported include flexion/extension at the elbow and wrist, forearm supination/pronation and digits 2–5 metacarpophalangeal (MCP) joint flexion/extension. Additionally for the thumb the angle between the metacarpal of the thumb and the 2nd digit (Thumb base), the thumb MCP (Thumb MCP) and interphalangeal (Thumb IP) joint angles are presented. Durations of activities performed at self-selected comfortable speeds (3.36 (IQR:3.07,3.66)s turning a key to 6.20 (IQR:5.44,6.38)s drinking from a glass) are reported. The maximum joint angles used (median of participants’ maxima) were 141° of elbow flexion, 116° forearm supination, 36° wrist extension, 56° Thumb base, 14° Thumb MCP flexion, 18° Thumb IP flexion, 85° MCP2-5 flexion. The tasks of drinking from a glass, lifting a bag to a shelf and turning a key appeared to have the least variation in performance, suggesting that these activities are better suited to be selected as standardized tasks for assessing the impact of pathology on movement than pouring from a kettle and turning a handle.
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Psychometric properties of outcome measures evaluating decline in gait in cerebellar ataxia: A systematic review
Source:Gait & Posture, Volume 61
Author(s): Sarah C. Milne, Anna Murphy, Nellie Georgiou-Karistianis, Eppie M. Yiu, Martin B. Delatycki, Louise A. Corben
Cerebellar ataxia often results in impairment in ambulation secondary to gait pattern dysfunction and compensatory gait adjustments. Pharmaceutical and therapy-based interventions with potential benefit for gait in ataxia are starting to emerge, however evaluation of such interventions is hampered by the lack of outcome measures that are responsive, valid and reliable for measurement of gait decline in cerebellar ataxia. This systematic review aimed for the first time to evaluate the psychometric properties of gait and walking outcomes applicable to individuals with cerebellar ataxia. Only studies evaluating straight walking were included. A comprehensive search of three databases (MEDLINE, CINAHL and EMBASE) identified 53 studies meeting inclusion criteria. Forty-nine were rated as ‘poor’ as assessed by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The primary objective of most studies was to explore changes in gait related to ataxia, rather than to examine psychometric properties of outcomes. This resulted in methodologies not specific for psychometric assessment. Thirty-nine studies examined validity, 11 examined responsiveness and 12 measured reliability. Review of the data identified double and single support and swing percentage of the gait cycle, velocity, step length and the Scale for Assessment and Rating of Ataxia (SARA) gait item as the most valid and responsive measures of gait in cerebellar ataxia. However, further evaluation to establish their reliability and applicability for use in clinical trials is clearly warranted. We recommend that inter-session reliability of gait outcomes should be evaluated to ensure changes are reflective of intervention effectiveness in cerebellar ataxia.
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Temporal-spatial gait parameter models of very slow walking
Source:Gait & Posture, Volume 61
Author(s): Andrew J.J. Smith, Edward D. Lemaire
This study assessed the relationship between walking speed and common temporal-spatial stride-parameters to determine if a change in gait strategy occurs at extremely slow walking speeds. Stride-parameter models that represent slow walking can act as a reference for lower extremity exoskeleton and powered orthosis controls since these devices typically operate at walking speeds less than 0.4 m/s. Full-body motion capture data were collected from 30 health adults while walking on a self-paced treadmill, within a CAREN-Extended virtual reality environment. Kinematic data were collected for 0.2–0.8 m/s, and self-selected walking speed. Eight temporal stride-parameters were determined and their relationship to walking speed was assessed using linear and quadratic regression. Stride-length, step-length, and step-frequency were linearly related to walking speed, even at speeds below 0.4 m/s. An inflection point at 0.5 m/s was found for stride-time, step-time, stance-time, and double support time. Equations were defined for each stride-parameter, with equation outputs producing correlations greater than 0.91 with the test data. This inflection point suggests a change in gait strategy at very slow walking speeds favouring greater ground contact time.
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Reported balance confidence and movement reinvestment of younger knee replacement patients are more like younger healthy individuals, than older patients
Source:Gait & Posture, Volume 61
Author(s): Brian D. Street, Allan Adkin, William Gage
This study focused on differences between the rapidly growing younger (<65 years old) and older (>65 years old) total knee replacement (TKR) patients for measures of balance confidence, movement reinvestment, and functional mobility. Fifty-nine participants, including twenty-nine primary unilateral TKR patients (six months post-TKR) formed the four experimental groups: 1) Younger TKR Patient (YP), 2) Younger Control (YC), 3) Older TKR Patient (OP), and 4) Older Control (OC). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Oxford Knee Score (OKS), Activities-specific Balance Confidence scale (ABC), the Movement-Specific Reinvestment Scale (MSRS), and the Timed Up and Go (TUG) test were measured. The YP group reported a significantly lower WOMAC score (p < 0.001), and higher perceived knee joint function (p = 0.001), compared to the OP group. The YP group also reported significantly higher balance confidence (p < 0.001) and less movement reinvestment (p = 0.001) than the OP group. TUG durations revealed that the YP group had significantly higher functional mobility compared to the OP group (p = 0.001). The YP group did not differ from the YC group across any of these measures (p > 0.05). These results identify a clear distinction between younger and older TKR patients for fall risk and TKR outcome, which argues that age should be a factor clinicians take into account when addressing the management and care of individuals recovering from TKR.
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Distal upper limb kinematics during functional everyday tasks
Source:Gait & Posture, Volume 61
Author(s): Ben Stansfield, Scott Rooney, Lisa Brown, Matthew Kay, Lisa Spoettl, Shivaramkumar Shanmugam
Quantitative characterisation of upper limb motion allows the evaluation of the effect of pathology on functional task performance, potentially directing rehabilitation strategies. Movement patterns of the distal upper limb in healthy adults during functional tasks have not been extensively characterised. During five loaded functional tasks (drinking from a glass, pouring from a kettle, turning a handle, lifting a bag to a shelf, turning a key) the movement patterns were characterised using three-dimensional motion analysis with a minimal marker set in 16 healthy adults (10 M,6F, 27 (IQR:25–43)years). Joint angles reported include flexion/extension at the elbow and wrist, forearm supination/pronation and digits 2–5 metacarpophalangeal (MCP) joint flexion/extension. Additionally for the thumb the angle between the metacarpal of the thumb and the 2nd digit (Thumb base), the thumb MCP (Thumb MCP) and interphalangeal (Thumb IP) joint angles are presented. Durations of activities performed at self-selected comfortable speeds (3.36 (IQR:3.07,3.66)s turning a key to 6.20 (IQR:5.44,6.38)s drinking from a glass) are reported. The maximum joint angles used (median of participants’ maxima) were 141° of elbow flexion, 116° forearm supination, 36° wrist extension, 56° Thumb base, 14° Thumb MCP flexion, 18° Thumb IP flexion, 85° MCP2-5 flexion. The tasks of drinking from a glass, lifting a bag to a shelf and turning a key appeared to have the least variation in performance, suggesting that these activities are better suited to be selected as standardized tasks for assessing the impact of pathology on movement than pouring from a kettle and turning a handle.
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Molecular characterization of autosomal recessive non syndromic hearing loss in selected families from District Mardan, Pakistan.
Molecular characterization of autosomal recessive non syndromic hearing loss in selected families from District Mardan, Pakistan.
Pak J Pharm Sci. 2018 Jan;31(1):51-56
Authors: Hussain S, Khattak JZ, Ismail M, Mansoor Q, Khan MH
Abstract
Deafness is the most common sensory disorder, which affects 1/1000 neonates globally. Genetic factors are major contributors for hearing impairment. This study was conducted to explore the linkage of DFNB loci and their mutations with NSHL in selected Pakistani families. We included 10 families with history of deafness from district Mardan, Pakistan. Blood sample (5ml) along with personal and clinical information was collected from the available family members including both diseased and un-affected individuals. Genomic DNA was amplified using loci specific STR markers to investigate the linkage of DFNB loci. Family found linked with DFNB4 locus was screened for SLC26A4 mutations. One out of the ten explored families was found linked with DFNB4 locus which was further investigated for SLC26A4 gene mutation through direct DNA sequencing. Two novel mutations were observed in the studied family, one at splice donor site (164+2T>G) and the other at position 164+5C>G only in the affected members of the linked family. DFNB4 locus was found linked in the present study which harbors SLC26A4 gene. The novel mutation of SLC26A4 gene at the splice donor site results in skipping of the first coding exon and thus can lead to loss of expression of SLC26A4 product in the inner ear.
PMID: 29348084 [PubMed - in process]
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Pediatric Audiology Report: Assessment and Revision of an Audiology Report Written to Parents of Children With Hearing Impairment.
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Related Articles |
Pediatric Audiology Report: Assessment and Revision of an Audiology Report Written to Parents of Children With Hearing Impairment.
J Speech Lang Hear Res. 2016 Apr 01;59(2):359-72
Authors: Donald AJ, Kelly-Campbell RJ
Abstract
OBJECTIVE: The purpose of this study was twofold: first, to evaluate a typical pediatric diagnostic audiology report to establish its readability and comprehensibility for parents and, second, to revise the report to improve its readability, as well as the comprehension, sense of self-efficacy, and positive opinions of parent readers.
METHOD: In Experiment 1, a mock audiology report was evaluated via a readability analysis and semistructured interviews with 5 parents. In Experiment 2, the report was revised using best practice guidelines and parental recommendations from Experiment 1. The revision was verified by randomly assigning 32 new parent participants to read either the revised or unrevised report before their comprehension, self-efficacy, and opinions were assessed.
RESULTS: In Experiment 1, results confirmed that the report was difficult to read and understand. In Experiment 2, parents who read the revised report had significantly greater comprehension, self-efficacy, and opinion ratings than those who read the unrevised report. In addition, the readability of the revised report was markedly improved compared with the unrevised report.
CONCLUSIONS: This study shows that pediatric diagnostic audiology reports can be revised to adhere to best practice guidelines and yield improved readability, in addition to improving the comprehension, sense of self-efficacy, and positive opinions of parents of children with hearing impairment.
PMID: 27111466 [PubMed - indexed for MEDLINE]
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