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

Effect of augmented feedback on motor function of the affected upper extremity in rehabilitation patients: a systematic review of randomized controlled trials

Objective: Assessment of the available evidence regarding the effect of augmented feedback on motor function of the upper extremity in rehabilitation patients.Methods: A systematic literature search was performed to identify randomized controlled trials that evaluated the effect of augmented feedback on motor function. Two reviewers systematically assessed the methodological quality of the trials. The reported effects were examined to evaluate the effect of therapeutic interventions using augmented feedback and to identify a possible relationship with patient characteristics, type of intervention, or methodological quality.Results: Twenty-six randomized controlled trials were included, 9 of which reported a positive effect on arm function tests. Follow-up measurements were performed in 8 trials, 1 of which reported a positive effect. Different therapeutic interventions using augmented feedback, i.e. electromyographic biofeedback, kinetic feedback, kinematic feedback, or knowledge of results, show no difference in effectiveness.Conclusion: No firm evidence was found of effectiveness regarding the use of augmented feedback to improve motor function of the upper extremity in rehabilitation patients. Future studies should focus more on the content, form and timing of augmented feedback concerning the therapeutic intervention. It should be emphasized that motor learning effects can only be determined by re-examining the population after a follow-up period. \u

Optimal Taylor-Couette flow: Radius ratio dependence

Taylor-Couette flow with independently rotating inner (i) and outer (o) cylinders is explored numerically and experimentally to determine the effects of the radius ratio {\eta} on the system response. Numerical simulations reach Reynolds numbers of up to Re_i=9.5 x 10^3 and Re_o=5x10^3, corresponding to Taylor numbers of up to Ta=10^8 for four different radius ratios {\eta}=r_i/r_o between 0.5 and 0.909. The experiments, performed in the Twente Turbulent Taylor-Couette (T^3C) setup, reach Reynolds numbers of up to Re_i=2x10^6$ and Re_o=1.5x10^6, corresponding to Ta=5x10^{12} for {\eta}=0.714-0.909. Effective scaling laws for the torque J^{\omega}(Ta) are found, which for sufficiently large driving Ta are independent of the radius ratio {\eta}. As previously reported for {\eta}=0.714, optimum transport at a non-zero Rossby number Ro=r_i|{\omega}_i-{\omega}_o|/[2(r_o-r_i){\omega}_o] is found in both experiments and numerics. Ro_opt is found to depend on the radius ratio and the driving of the system. At a driving in the range between {Ta\sim3\cdot10^8} and {Ta\sim10^{10}}, Ro_opt saturates to an asymptotic {\eta}-dependent value. Theoretical predictions for the asymptotic value of Ro_{opt} are compared to the experimental results, and found to differ notably. Furthermore, the local angular velocity profiles from experiments and numerics are compared, and a link between a flat bulk profile and optimum transport for all radius ratios is reported.Comment: Submitted to JFM, 28 pages, 17 figure

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

Influence of gravity compensation on muscle activity during reach and retrieval in healthy elderly.

INTRODUCTION: Arm support like gravity compensation may improve arm movements during stroke rehabilitation. It is unknown how gravity compensation affects muscle activation patterns during reach and retrieval movements. Since muscle activity during reach is represented by a component varying with movement velocity and a component supposedly counteracting gravity, we hypothesized that gravity compensation decreases the amplitude of muscle activity, but does not affect the pattern. To examine this, we compared muscle activity during well defined movements with and without gravity compensation in healthy elderly. METHODS: Ten subjects performed reach and retrieval movements with and without gravity compensation. Muscle activity of biceps, triceps, anterior, middle and posterior parts of deltoid and upper trapezius was compared between the two conditions. RESULTS: The level of muscle activity was lower with gravity compensation in all muscles, reaching significance in biceps, anterior deltoid and trapezius (p0.026). The muscle activation pattern did not differ between movements with and without gravity compensation (p0.662). DISCUSSION: Gravity compensation only influenced the level of muscle activity but not the muscle activation pattern in terms of timing. Future studies should examine if the influence of gravity compensation is comparable for stroke patients. This may stimulate early and intensive training during rehabilitation

Genomic mating in outbred species: predicting cross usefulness with additive and total genetic covariance matrices

Open Access Article; Published online: 03 Sep 2021Diverse crops are both outbred and clonally propagated. Breeders typically use truncation selection of parents and invest significant time, land, and money evaluating the progeny of crosses to find exceptional genotypes. We developed and tested genomic mate selection criteria suitable for organisms of arbitrary homozygosity level where the full-sibling progeny are of direct interest as future parents and/or cultivars. We extended cross variance and covariance variance prediction to include dominance effects and predicted the multivariate selection index genetic variance of crosses based on haplotypes of proposed parents, marker effects, and recombination frequencies. We combined the predicted mean and variance into usefulness criteria for parent and variety development. We present an empirical study of cassava (Manihot esculenta), a staple tropical root crop. We assessed the potential to predict the multivariate genetic distribution (means, variances, and trait covariances) of 462 cassava families in terms of additive and total value using cross-validation. Most variance (89%) and covariance (70%) prediction accuracy estimates were greater than zero. The usefulness of crosses was accurately predicted with good correspondence between the predicted and the actual mean performance of family members breeders selected for advancement as new parents and candidate varieties. We also used a directional dominance model to quantify significant inbreeding depression for most traits. We predicted 47,083 possible crosses of 306 parents and contrasted them to those previously tested to show how mate selection can reveal the new potential within the germplasm. We enable breeders to consider the potential of crosses to produce future parents (progeny with top breeding values) and varieties (progeny with top own performance)