scholarly journals Rhythmic Haptic Cueing Using Wearable Devices as Physiotherapy for Huntington Disease: Case Study

10.2196/18589 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e18589 ◽  
Author(s):  
Theodoros Georgiou ◽  
Riasat Islam ◽  
Simon Holland ◽  
Janet van der Linden ◽  
Blaine Price ◽  
...  
Keyword(s):  
Situation Awareness ◽  
Huntington Disease ◽  
Repeated Measures ◽  
Genetic Disorder ◽  
Wearable Devices ◽  
Repeated Measures Design ◽  
Therapeutic Benefits ◽  
Disease Case ◽  
Neurological Conditions

Background Huntington disease (HD) is an inherited genetic disorder that results in the death of brain cells. HD symptoms generally start with subtle changes in mood and mental abilities; they then degenerate progressively, ensuing a general lack of coordination and an unsteady gait, ultimately resulting in death. There is currently no cure for HD. Walking cued by an external, usually auditory, rhythm has been shown to steady gait and help with movement coordination in other neurological conditions. More recently, work with other neurological conditions has demonstrated that haptic (ie, tactile) rhythmic cues, as opposed to audio cues, offer similar improvements when walking. An added benefit is that less intrusive, more private cues are delivered by a wearable device that leaves the ears free for conversation, situation awareness, and safety. This paper presents a case study where rhythmic haptic cueing (RHC) was applied to one person with HD. The case study has two elements: the gait data we collected from our wearable devices and the comments we received from a group of highly trained expert physiotherapists and specialists in HD. Objective The objective of this case study was to investigate whether RHC can be applied to improve gait coordination and limb control in people living with HD. While not offering a cure, therapeutic outcomes may delay the onset or severity of symptoms, with the potential to improve and prolong quality of life. Methods The approach adopted for this study includes two elements, one quantitative and one qualitative. The first is a repeated-measures design with three conditions: before haptic rhythm (ie, baseline), with haptic rhythm, and after exposure to haptic rhythm. The second element is an in-depth interview with physiotherapists observing the session. Results In comparison to the baseline, the physiotherapists noted a number of improvements to the participant’s kinematics during her walk with the haptic cues. These improvements continued in the after-cue condition, indicating some lasting effects. The quantitative data obtained support the physiotherapists’ observations. Conclusions The findings from this small case study, with a single participant, suggest that a haptic metronomic rhythm may have immediate, potentially therapeutic benefits for the walking kinematics of people living with HD and warrants further investigation.

scholarly journals Rhythmic Haptic Cueing Using Wearable Devices as Physiotherapy for Huntington Disease: Case Study (Preprint)

2020 ◽  
Author(s):  
Theodoros Georgiou ◽  
Riasat Islam ◽  
Simon Holland ◽  
Janet van der Linden ◽  
Blaine Price ◽  
...  
Keyword(s):  
Situation Awareness ◽  
Huntington Disease ◽  
Repeated Measures ◽  
Genetic Disorder ◽  
Wearable Devices ◽  
Repeated Measures Design ◽  
Therapeutic Benefits ◽  
Disease Case ◽  
Neurological Conditions

BACKGROUND Huntington disease (HD) is an inherited genetic disorder that results in the death of brain cells. HD symptoms generally start with subtle changes in mood and mental abilities; they then degenerate progressively, ensuing a general lack of coordination and an unsteady gait, ultimately resulting in death. There is currently no cure for HD. Walking cued by an external, usually auditory, rhythm has been shown to steady gait and help with movement coordination in other neurological conditions. More recently, work with other neurological conditions has demonstrated that haptic (ie, tactile) rhythmic cues, as opposed to audio cues, offer similar improvements when walking. An added benefit is that less intrusive, more private cues are delivered by a wearable device that leaves the ears free for conversation, situation awareness, and safety. This paper presents a case study where rhythmic haptic cueing (RHC) was applied to one person with HD. The case study has two elements: the gait data we collected from our wearable devices and the comments we received from a group of highly trained expert physiotherapists and specialists in HD. OBJECTIVE The objective of this case study was to investigate whether RHC can be applied to improve gait coordination and limb control in people living with HD. While not offering a cure, therapeutic outcomes may delay the onset or severity of symptoms, with the potential to improve and prolong quality of life. METHODS The approach adopted for this study includes two elements, one quantitative and one qualitative. The first is a repeated-measures design with three conditions: before haptic rhythm (ie, baseline), with haptic rhythm, and after exposure to haptic rhythm. The second element is an in-depth interview with physiotherapists observing the session. RESULTS In comparison to the baseline, the physiotherapists noted a number of improvements to the participant’s kinematics during her walk with the haptic cues. These improvements continued in the after-cue condition, indicating some lasting effects. The quantitative data obtained support the physiotherapists’ observations. CONCLUSIONS The findings from this small case study, with a single participant, suggest that a haptic metronomic rhythm may have immediate, potentially therapeutic benefits for the walking kinematics of people living with HD and warrants further investigation.

scholarly journals Tracking Children’s Physical Activity Patterns across the School Year: A Mixed-Methods Longitudinal Case Study

Children ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. 178
Author(s):  
Irfan Khawaja ◽  
Lorayne Woodfield ◽  
Peter Collins ◽  
Adam Benkwitz ◽  
Alan Nevill
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Focus Groups ◽  
Repeated Measures ◽  
Vigorous Physical Activity ◽  
Activity Patterns ◽  
Positioning Systems ◽  
Repeated Measures Design ◽  
School Year

Despite the breadth of health benefits associated with regular physical activity (PA), many children in the UK are not sufficiently active enough to meet health guidelines, and tend to become less active as they mature into and throughout adolescence. Research has indicated that children’s school, home and neighbourhood environments can all significantly influence their opportunities to engage in moderate-to-vigorous physical activity (MVPA). However, less is known about how children’s MVPA patterns within these key environments may change across the school year. The current mixed-methods case study aims to explore this issue by tracking key stage 2 (KS2) and key stage 3 (KS3) children’s MVPA patterns across the school year. Fifty-eight children (29 boys, 29 girls, KS2 = 34, KS3 = 24) wore an integrated global positioning systems (GPS) and heart rate (HR) monitor over four consecutive days in the first term of school (autumn), before these measurements were repeated in the two remaining school terms (winter–summer). A subsample of children (n = 6–8 per group) were invited to take part in one of six focus groups each term to further explore their PA behaviours and identify the barriers and facilitators to PA. The children’s MVPA was significantly lower (p = 0.046) in term 2 (winter/spring term) than during the warmer terms (autumn and summer). All the locations showed reductions in MVPA in term 2, except indoor MVPA, which increased, and MVPA on foot in the neighbourhood, which remained consistent. Focus groups revealed location, friends, and the variety of options to be associated with MVPA, and poor weather, parental permission, and time limitations to be barriers to MVPA. This mixed-methodological, repeated-measures design study highlights differences in the activity patterns and perceptions of children over the school year. Future studies should implement longitudinal, multi-method approaches to gain deeper insight into how children’s PA behaviours differ over time. Consequently, this can inform future health policies promoting children’s PA throughout the year.

Basic Study Designs

2018 ◽  
pp. 68-86
Author(s):  
Alexandra Gomez ◽  
Felipe Fregni ◽  
Vera Novak ◽  
Andre Brunoni
Keyword(s):  
Repeated Measures ◽  
Real Life ◽  
Basic Study ◽  
Repeated Measures Design ◽  
Parallel Group ◽  
Control Comparison ◽  
Quasi Experimental ◽  
Comparison Trial ◽  
Study Designs

This chapter on basic study designs provides an overview of the most common design methodologies used in interventional studies. The chapter discusses both the advantages and limitations of parallel group designs (placebo or active control comparison trial, factorial design), repeated measures design (cross-over or between-subjects design), and quasi-experimental designs. It provides examples and discusses designs that are used in specific settings (for example, rare diseases, phases of dug development, and interventions in real life, including large simple trials, N-of-1). The chapter ends with a case study that illustrates the in-depth application of the available options into practice.

scholarly journals Learning from Online Modules in Diverse Instructional Contexts

10.28945/3511 ◽  
2016 ◽  
Vol 12 ◽  
pp. 113-121
Author(s):  
Gwen Nugent ◽  
Amy Kohmetscher ◽  
Deana M. Namuth-Covert ◽  
John Guretzky Guretzky ◽  
Patrick Murphy ◽  
...  
Keyword(s):  
Online Learning ◽  
Repeated Measures ◽  
Learning Objects ◽  
Face To Face ◽  
Study Approach ◽  
Online Module ◽  
Repeated Measures Design ◽  
Final Exams ◽  
Face To Face Instruction

Learning objects originally developed for use in online learning environments can also be used to enhance face-to-face instruction. This study examined the learning impacts of online learning objects packaged into modules and used in different contexts for undergraduate education offered on campus at three institutions. A multi-case study approach was used, examining learning impacts across a variety of course subjects, course levels (introductory and advanced undergraduate), student levels (undergraduate and graduate), and instructional goals (i.e., replacement for lecture, remediation). A repeated measures design was used, with learning data collected prior to viewing the online module, after completion of the module, and at the end of the semester. The study provided a broad examination of ways that online modules are typically used in a college classroom, as well as measured learning effectiveness based on different instructional purpose and usage contexts. Results showed the effectiveness of the modules in serving as a substitute for classroom lecture, remediation of course prerequisite material, introduction to content with follow-up lab practice, and review for final exams. In each of these cases, the use of the modules resulted in significant learning increases, as well as retention of the learning until the end of the semester.

scholarly journals Assessing levels of similarity to a "psychodynamic prototype" in psychodynamic psychotherapy with children: a case study approach (preliminary findings)

2015 ◽  
Vol 37 (3) ◽  
pp. 161-165 ◽  
Author(s):  
Marina Bento Gastaud ◽  
Cibele Carvalho ◽  
Geoff Goodman ◽  
Vera Regina Röhnelt Ramires
Keyword(s):  
Repeated Measures ◽  
Behavioral Therapy ◽  
Theory And Practice ◽  
First Year ◽  
Case Study Method ◽  
Study Approach ◽  
Repeated Measures Design ◽  
Psychotherapy Theory ◽  
Video And Audio

Objective:To analyze the degree of similarity to a "psychodynamic prototype" during the first year of two children's once-weekly psychodynamic psychotherapy.Methods: This study used a longitudinal, descriptive, repeated-measures design based on the systematic case study method. Two male school children (here referred to as Walter and Peter) and their therapists took part in the study. All sessions were video and audio recorded. Ten sessions from each case were selected for analysis in this preliminary study. Trained examiners (randomly selected in pairs) independently and blindly evaluated each session using the Child Psychotherapy Q-Set (CPQ). Experts in psychodynamic therapy and cognitive behavioral therapy from several countries rated each of the 100 CPQ items with regard to how well it characterized a hypothetical ideal session of either treatment modality. A series of paired t tests comparing analogous adherence scores within each session were conducted.Results:There were no significant correlations between time elapsed and adherence to the prototypes. Walter's treatment adhered to both prototypes and Peter's treatment did not adhere to either prototype.Conclusion:Child psychotherapy theory and practice are not absolutely coincident. Real psychotherapy sessions do not necessarily resemble the ideal prototypes.

Power of Modified Brown-Forsythe and Mixed-Model Approaches in Split-Plot Designs

Methodology ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Pablo Livacic-Rojas ◽  
Guillermo Vallejo ◽  
Paula Fernández ◽  
Ellián Tuero-Herrero
Keyword(s):  
Repeated Measures ◽  
Statistical Power ◽  
Mixed Model ◽  
Covariance Structure ◽  
Simulation Method ◽  
Future Research ◽  
Repeated Measures Design ◽  
Fixed And Random Effects ◽  
Split Plot ◽  
High Level

Abstract. Low precision of the inferences of data analyzed with univariate or multivariate models of the Analysis of Variance (ANOVA) in repeated-measures design is associated to the absence of normality distribution of data, nonspherical covariance structures and free variation of the variance and covariance, the lack of knowledge of the error structure underlying the data, and the wrong choice of covariance structure from different selectors. In this study, levels of statistical power presented the Modified Brown Forsythe (MBF) and two procedures with the Mixed-Model Approaches (the Akaike’s Criterion, the Correctly Identified Model [CIM]) are compared. The data were analyzed using Monte Carlo simulation method with the statistical package SAS 9.2, a split-plot design, and considering six manipulated variables. The results show that the procedures exhibit high statistical power levels for within and interactional effects, and moderate and low levels for the between-groups effects under the different conditions analyzed. For the latter, only the Modified Brown Forsythe shows high level of power mainly for groups with 30 cases and Unstructured (UN) and Autoregressive Heterogeneity (ARH) matrices. For this reason, we recommend using this procedure since it exhibits higher levels of power for all effects and does not require a matrix type that underlies the structure of the data. Future research needs to be done in order to compare the power with corrected selectors using single-level and multilevel designs for fixed and random effects.

Lifestyle intervention using modified BASNEF model in hypertension management (Preprint)

2020 ◽  
Author(s):  
Resti Tito Villarino ◽  
Christopher Arcay ◽  
Maria Concepcion Temblor
Keyword(s):  
Lifestyle Intervention ◽  
Repeated Measures ◽  
Intervention Program ◽  
Phase 1 ◽  
Management Technique ◽  
Enabling Factors ◽  
Educational Models ◽  
Stroke Risk Factor ◽  
Repeated Measures Design ◽  
Lifestyle Intervention Program

BACKGROUND Hypertension is a serious health issue and a major cardiovascular disease and stroke risk factor. In hypertensive patients, various health educational models have been used to improve their lifestyle, but the findings are inconsistent. OBJECTIVE The study assessed the effects of a lifestyle intervention program using modified Beliefs, Attitude, Subjective Standards, Enabling Factors (BASNEF) model among non-adherent hypertensive respondents in relation to the introduction of a lifestyle intervention program in the management of hypertension. METHODS This is a quantitative quasi-experimental research particularly utilizing a repeated-measures design of within-subjects approach on the 50 non-adherent patients diagnosed with essential hypertension at Moalboal, Cebu, Philippines in 2019. The respondents received five sessions of trainings based on modified BASNEF model. The Morisky Medication Adherence instrument was used. The first phase included a demographic questionnaire and the last phase comprised the evaluation of the program. Frequencies, percentages, means and standard deviations for descriptive statistics while t-test, repeated measures, ANOVA, and Pearson product moment correlation for inferential statistics. RESULTS The result indicated that the phase 1 mean (146.5) of the systolic readings differ significantly from the phase 4 mean (134.92) of the systolic readings. However, since these two means came from phases that were not consecutive, the result, as a whole, did not show a significant decrease or change when analyzed chronologically from one phase to the next. CONCLUSIONS The study has established that BASNEF model approach can be an effective BP management technique.

Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Comparison Group ◽  
Care Delivery ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Positive Effects ◽  
Repeated Measures Design ◽  
Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

scholarly journals The Acute Effects of a Swimming Session on the Shoulder Rotators Strength and Balance of Age Group Swimmers

2021 ◽  
Vol 18 (15) ◽  
pp. 8109
Author(s):  
Nuno Batalha ◽  
Jose A. Parraca ◽  
Daniel A. Marinho ◽  
Ana Conceição ◽  
Hugo Louro ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Training Session ◽  
Age Group ◽  
Acute Effects ◽  
Muscle Strengthening ◽  
Repeated Measures Design ◽  
Before And After ◽  
Shoulder Strength ◽  
Isometric Torque ◽  
Gender Specific

The purpose of this study was to analyze the acute effects of a standardized water training session on the shoulder rotators strength and balance in age group swimmers, in order to understand whether a muscle-strengthening workout immediately after the water training is appropriate. A repeated measures design was implemented with two measurements performed before and after a standardized swim session. 127 participants were assembled in male (n = 72; age: 16.28 ± 1.55 years, height: 174.15 ± 7.89 cm, weight: 63.97 ± 6.51 kg) and female (n = 55; age: 15.29 ± 1.28 years, height: 163.03 ± 7.19 cm, weight: 52.72 ± 5.48 kg) cohorts. The isometric torque of the shoulder internal (IR) and external (ER) rotators, as well as the ER/IR ratios, were assessed using a hand-held dynamometer. Paired sample t-tests and effect sizes (Cohen’s d) were used (p ≤ 0.05). No significant differences were found on the shoulder rotators strength or balance in males after training. Females exhibited unchanged strength values after practice, but there was a considerable decrease in the shoulder rotators balance of the non-dominant limb (p < 0.01 d = 0.366). This indicates that a single practice seems not to affect the shoulders strength and balance of adolescent swimmers, but this can be a gender specific phenomenon. While muscle-strengthening workout after the water session may be appropriate for males, it can be questionable regarding females. Swimming coaches should regularly assess shoulder strength levels in order to individually identify swimmers who may or may not be able to practice muscle strengthening after the water training.

scholarly journals The use of multiple-criteria decision-making theory to measure students’ perceptions of high-fidelity simulation

2017 ◽  
Vol 3 (3) ◽  
pp. 88-93 ◽  
Author(s):  
Maureen Anne Jersby ◽  
Paul Van-Schaik ◽  
Stephen Green ◽  
Lili Nacheva-Skopalik
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Repeated Measures ◽  
Clinical Decision Making ◽  
Learning Experience ◽  
Clinical Decision ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Initial Exposure ◽  
Repeated Measures Design

BackgroundHigh-Fidelity Simulation (HFS) has great potential to improve decision-making in clinical practice. Previous studies have found HFS promotes self-confidence, but its effectiveness in clinical practice has not been established. The aim of this research is to establish if HFS facilitates learning that informs decision-making skills in clinical practice using MultipleCriteria DecisionMaking Theory (MCDMT).MethodsThe sample was 2nd year undergraduate pre-registration adult nursing students.MCDMT was used to measure the students’ experience of HFS and how it developed their clinical decision-making skills. MCDMT requires characteristic measurements which for the learning experience were based on five factors that underpin successful learning, and for clinical decision-making, an analytical framework was used. The study used a repeated-measures design to take two measurements: the first one after the first simulation experience and the second one after clinical placement. Baseline measurements were obtained from academics. Data were analysed using the MCDMT tool.ResultsAfter their initial exposure to simulation learning, students reported that HFS provides a high-quality learning experience (87%) and supports all aspects of clinical decision-making (85%). Following clinical practice, the level of support for clinical decision-making remained at 85%, suggesting that students believe HFS promotes transferability of knowledge to the practice setting.ConclusionOverall, students report a high level of support for learning and developing clinical decision-making skills from HFS. However, there are no comparative data available from classroom teaching of similar content so it cannot be established if these results are due to HFS alone.

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