PHASE ANGLE IS LOWERED IN THE SURGICAL LIMB TWO-WEEKS AFTER KNEE SURGERY

Christopher J. Cleary1, Bryan G. Vopat2, Ashley A. Herda1 1University of Kansas Edwards Campus, Overland Park, Kansas, 2 University of Kansas Health Systems, Overland Park, Kansas Phase angle (PhA) is derived from bioelectrical impedance analysis (BIA), representative of cell membrane integrity and thought to be a surrogate for muscle function. Therefore, PhA may be a useful, easily assessed outcome to track in times when traditional muscle function tests are contraindicated, such as after anterior cruciate ligament reconstruction surgery. PURPOSE: The purpose of this project was to assess differences in segmental PhA between the operative (OP) and non-operative (NO) legs in knee surgery patients and their relationships with whole-body and segmental lean mass. METHODS: Twenty (13 M, 7 F, mean±SD: 18.2±4.6 years; 177.1±9.9 m; 80.8±19.7 kg) knee surgery patients were assessed two-weeks after surgery as part of their normal physical therapy visits. BIA assessed whole-body and segmental (OP and NO leg) PhA and lean muscle masses. Data were analyzed using paired-samples t-test to assess any differences between OP and NO legs and Pearson’s correlations assessed the relationships between OP and NO leg PhA and whole body and segmental (OP and NO) lean masses. Data were considered significant at p\u3c0.05. RESULTS: For PhA, the NO leg (6.8±0.7°) was significantly greater (p\u3c0.001) than the OP leg (5.5±0.9°). However, OP leg lean mass (9.7±2.0 kg) was estimated as greater (p\u3c0.001) than NO leg lean mass (9.4±1.9 kg). There was no significant relationship between OP PhA and OP lean mass (r=0.34, p=0.14), while NO PhA significantly correlated with NO lean mass (r=0.47, p=0.039). PhA of both legs was significantly related to total body lean mass, but NO PhA was more strongly related (r=0.58, p=0.008) than the OP leg (r=0.49, p=0.027). CONCLUSION: PhA was significantly greater in the NO leg by approximately 22% two-weeks after knee surgery, while NO leg lean mass was less than the OP leg by approximately 3%. The estimate of OP lean muscle and differences between legs may be representative of intra-and extracellular swelling post-surgery. These differences in PhA may represent altered cellular integrity, and potentially function, in the OP leg. Bioelectrical impedance therefore may be an advantageous way to non-invasively interpret muscle function early after surgery

The teachers’ role in developing, opening, and nurturing an inclusive STEM-focused school

This study is about teachers’ collective activity during the development and initial year of a science, technology, engineering, and mathematics (STEM)-focused school in the USA. The target school of this study was inclusive, as it sought admission of students from varying backgrounds and levels of ability. Drawing from narrative inquiry and case study methodologies, we examine the collective work of the teachers in the target school from 6 months prior to school start-up through the end of the first year. We focus on visioning, collaboration, and curriculum development in our analysis of the teachers’ collective work.We analyze the collective sense-making activity of the teaching staff regarding key facets of the start-up process. While the teachers received a variety of supports, including time and resources for collaborating, there was a lack of specific support for the conceptualization and creation of multi-disciplinary, STEM-focused projects. The risk-taking and collaborative actions of the teachers led to three specific instructional approaches that were continuously adjusted to respond to the evolving vision of the STEM-focused school. The teachers also solicited the needs and interests of their students and utilized these in curricular design and instruction, which promoted student buy-in and participation. By the end of the school year, a common vision for STEM-focused, project-based learning was emerging, but not solidified.Our study confirms the power of doing and risk-taking in teacher development, particularly in the ways in which teacher collaboration advanced curriculum and instruction in this STEM-focused school context. The intellectual supports that teachers require in this context are numerous and must be carefully identified and nurtured, and the subsequent teacher activity must be monitored as contextual shifts occur and sources of pressure (e.g., external learning standards) become relevant. The teachers’ role is a complex mixture of learner, risk-taker, inquirer, curriculum designer, negotiator, collaborator, and teacher. Instructional and curricular supports require substantial time to synthesize and eventually enact, and more than a few months prior to school start-up are necessary to fully engage and prepare teachers for the collective task of visioning, collaborating, and planning the curriculum and instruction of an innovative school