Use and usability of custom-made orthopedic shoes

The goal of this study was to investigate the use of custom-made orthopedic shoes (OS) and the association between the use of OS and the most relevant aspects of their usability. Over a 6-month period, patients meeting the inclusion criteria were recruited by 12 orthopedic shoe companies scattered throughout the Netherlands and asked to complete a questionnaire composed of a pre- and post-OS section. Patients with different pathologies were included in the study (n = 339; response 67%). Mean age of the patients was 63 +/- 15 years, and 38% were male. Three months after delivery, 81% of the patients used their OS frequently (4-7 days/week), 13% occasionally (1-3 days/week), and 6% did not use their OS. Associations were found between use and all measured aspects of usability (p-values varied from <0.001 to 0.028). Patients who used their OS more often had a more positive opinion regarding all the aspects of usability. We conclude that all aspects of the usability of OS are relevant in relation to their use and should be taken into account when prescribing and evaluating OS

Changes in circle area after gravity compensation training in chronic stroke patients

After a stroke, many people experience difficulties to selectively activate muscles. As a result many patients move the affected arm in stereotypical patterns. Shoulder abduction is often accompanied by elbow flexion, reducing the ability to extend the elbow. This involuntary coupling reduces the patient's active range of motion. Gravity compensation reduces the activation level of shoulder abductors which limits the amount of coupled elbow flexion. As a result, stroke patients can instantaneously increase their active range of motion [1]. The objective of the present study is to examine whether training in a gravity compensated environment can also lead to an increased range of motion in an unsupported environment. Parts of this work have been presented at EMBC2009, Minneapolis, USA

In Vitro Bile Acid Binding of Flours from Oat Lines Varying in Percentage and Molecular Weight Distribution of β-Glucan

Two experimental high β-glucan oat (Avena sativa) lines (7.64 and 8.05%) and two traditional lines (4.77 and 5.26% β-glucan) were used to evaluate the effect of β-glucan quantity and molecular weight on bile acid (BA) binding. The oat flour samples were digested by an in vitro system that simulated human digestion. No significant differences among oat type were found in the overall β-glucan, starch, and pentosan digestibilities. Considering the standard, cholestyramine, as 100% bound, the relative BA binding for the oat flour samples on a dry matter basis was in the range of 7.5−14.8%, which is higher than the values determined for some other grains and plant materials in the literature. Although the high β-glucan flours bound a high amount of BA, no significant correlations were found between β-glucan content in the flours and BA binding. Significant correlations were found between BA binding and insoluble dietary fiber content. Partial hydrolysis with lichenase of the β-glucan molecules did not affect the BA binding. A summary of all data suggested that BA binding is a multicomponent-dependent process

In Vitro Bile Acid Binding Activity within Flour Fractions from Oat Lines with Typical and High β-Glucan Amounts

Whole flours from four oat lines with different amounts of β-glucan (4.8−8.1%) were examined for their antioxidant activity and total phenolic and lignin concentrations. These data, along with the β-glucan percentages, were compared with bile acid (BA) binding. Only the lignin concentrations of the flours significantly (P \u3c 0.01) correlated with the BA binding values. The oat flours also were fractionated into bran, protein concentrate, starch, layer above starch, and soluble β-glucan (SBG)-free flour, and their BA binding capacities were evaluated. The bran fractions were the only fractions that bound greater BA than did the whole oat flours on dry matter basis. Extraction of the soluble β-glucan to create the SBG-free flour significantly (P \u3c 0.01) decreased the BA binding of the remaining flour. These data suggest that BA binding of the oat flours involves the synergistic interactions of the oat components, with β-glucan and lignin (insoluble fiber) having a great impact

Performance of Single Nucleotide Polymorphisms versus Haplotypes for Genome-Wide Association Analysis in Barley

Genome-wide association studies (GWAS) may benefit from utilizing haplotype information for making marker-phenotype associations. Several rationales for grouping single nucleotide polymorphisms (SNPs) into haplotype blocks exist, but any advantage may depend on such factors as genetic architecture of traits, patterns of linkage disequilibrium in the study population, and marker density. The objective of this study was to explore the utility of haplotypes for GWAS in barley (Hordeum vulgare) to offer a first detailed look at this approach for identifying agronomically important genes in crops. To accomplish this, we used genotype and phenotype data from the Barley Coordinated Agricultural Project and constructed haplotypes using three different methods. Marker-trait associations were tested by the efficient mixed-model association algorithm (EMMA). When QTL were simulated using single SNPs dropped from the marker dataset, a simple sliding window performed as well or better than single SNPs or the more sophisticated methods of blocking SNPs into haplotypes. Moreover, the haplotype analyses performed better 1) when QTL were simulated as polymorphisms that arose subsequent to marker variants, and 2) in analysis of empirical heading date data. These results demonstrate that the information content of haplotypes is dependent on the particular mutational and recombinational history of the QTL and nearby markers. Analysis of the empirical data also confirmed our intuition that the distribution of QTL alleles in nature is often unlike the distribution of marker variants, and hence utilizing haplotype information could capture associations that would elude single SNPs. We recommend routine use of both single SNP and haplotype markers for GWAS to take advantage of the full information content of the genotype data

Development and reproducibility of a short questionnaire to measure use and usability of custom-made orthopaedic shoes

Objective: To develop a short and easy to use questionnaire to measure use and usability of custom-made orthopaedic shoes, and to investigate its reproducibility.\ud Design: Development of the questionnaire (Monitor Orthopaedic Shoes) was based on a literature search, expert interviews, 2 expert meetings, and exploration and testing of reproducibility. The questionnaire comprises 2 parts: a pre part, measuring expectations; and a post part, measuring experiences.\ud Patients: The pre part of the final version was completed twice by 37 first-time users before delivery of their orthopaedic shoes. The post part of the final version was completed twice by 39 first-time users who had worn their orthopaedic shoes for 2–4 months.\ud Results: High reproducibility scores (Cohen’s kappa > 0.60 or intra class correlation > 0.70) were found in all but one question of both parts of the final version of the Monitor Orthopaedic Shoes questionnaire. The smallest real difference on a visual analogue scale (100 mm) ranged from 21 to 50 mm. It took patients approximately 15 minutes to complete one part.\ud Conclusion: Monitor Orthopaedic Shoes is a practical and reproducible questionnaire that can measure relevant aspects of use and usability of orthopaedic shoes from a patient’s perspective

Questionnaire for usability evaluation of orthopaedic shoes: construction and reliability in patients with degenerative disorders of the foot

Objective: To develop a self-report questionnaire for patients with degenerative disorders of the foot to evaluate the usability of their orthopaedic shoes, and to assess the reproducibility and responsiveness of the instrument. Design: Development of the Questionnaire for Usability Evaluation of orthopaedic shoes was based on a literature search, structured expert interviews and a ranking procedure. A cross-sectional study was carried out to determine the reproducibility and internal consistency of the questionnaire. Setting and subjects: The study population comprised 15 patients with degenerative disorders of the foot, who had worn their orthopaedic shoes for at least 3 years and 15 patients with degenerative disorders of the foot, who had never worn orthopaedic shoes, but would receive them within 1 month. Results: Within the questionnaire 4 effectiveness items (pain, instability, callus, wounds), 1 efficiency item (putting on and taking off shoes) and 7 satisfaction items (pinch, slip, weight of shoes, cold feet, perspiration, maintenance, cosmetic appearance) were developed. All items in the questionnaire met the test-retest criteria. The smallest real difference ranged from 0.23 to 3.82 cm on a Visual Analogue Scale (10 cm). Cronbach's alpha's for the domains of pain and instability ranged from 0.70 to 0.92. Conclusion: The Questionnaire for Usability Evaluation should provide a good rationale to assess the usability of orthopaedic shoes and can be considered reliable

An explorative, cross-sectional study into abnormal muscular coupling during reach in chronic stroke patients

Background\ud In many stroke patients arm function is limited, which can be related to an abnormal coupling between shoulder and elbow joints. The extent to which this can be translated to activities of daily life (ADL), in terms of muscle activation during ADL-like movements, is rather unknown. Therefore, the present study examined the occurrence of abnormal coupling on functional, ADL-like reaching movements of chronic stroke patients by comparison with healthy persons.\ud \u