Halliwick-Based Aquatic Assessments : Reliability and Validity

Purpose: To investigate the reliability and validity of 2 aquatic functional assessment tests (Water Orientation Test of Alyn 1 and 2: WOTA1, WOTA2) for evaluating adjustment and functional ability in the aquatic environment based on the Halliwick concept. Methods: Thirty-two children with disabilities participated in the reliability study. Thirty-three other children participated in the validity study, which tested the correlations between the WOTA total score and motor performance on land. Results: Test-retest reliability for total score was found to be excellent for both WOTA1 (ICC = .97) and WOTA2 (ICC = 0.93, 0.97). The reliability for most of the individual item scores was fair to good (kappa \u3e 0.4). A positive moderately significant association was found between the WOTA total score and motor performance on land. Conclusion: Both assessments appear to be reliable and valid instruments for assessing mental adjustment and aquatic function in children with disabilities

Towards Upright Pedalling to drive recovery in people who cannot walk in the first weeks after stroke: movement patterns and measurement

Objectives: To examine whether people who are within 31 days of stroke onset are able to produce controlled lower limb movement, and phasic activity in antagonistic lower limb muscle groups, during Upright Pedalling (UP). Design: Observational study. Setting: Acute stroke unit within a University Hospital. Participants: Eight adults between 3 and 30 days from stroke onset, with unilateral lower limb paresis and unable to walk without assistance. Participants were considered fit to participate as assessed by a physician-led medical team and were able to take part in UP for one, one minute session. Intervention: Participants took part in one session of instrumented UP at their comfortable cadence, as part of a feasibility study investigating UP early after stroke. Outcome measures: Reciprocal activation of lower limb muscles derived from muscle activity recorded with surface EMG, quantified using Jaccards Coefficient (J); smoothness of pedalling determined from standard deviations of time spent in each of eight 45 degree wheel position bins (“S-Ped”). Motor behavioural measures: Motricity Index, Trunk Control Test, Functional Ambulatory Categories. Results: Participants were all unable to walk (FAC 0) with severe to moderate lower limb paresis (Motricity Index score/100 median 48.5, IQR 32-65.5). Smooth pedalling was observed; some participants pedalling similarly smoothly to healthy older adults, with a variety of muscle activation patterns in the affected and unaffected legs. Conclusion: These observational data indicate that people with substantial paresis early after stroke and who cannot walk, can produce smooth movement during UP using a variety of muscle activation strategies

Fayet-Iliopoulos D-terms, neutrino masses and anomaly mediated supersymmetry breaking

We explore, in the context of the MSSM generalised to admit massive neutrinos, an extension of the Anomaly Mediated Supersymmetry Breaking solution for the soft scalar masses to incorporate Fayet-Iliopoulos D-terms. The slepton mass problem characteristic of the scenario is resolved, and the fermion mass hierarchy is explained via the Froggatt-Nielsen mechanism. FCNC problems are evaded by a combination of universal doublet charges and Yukawa textures which are diagonalised by transforming the left-handed fields only.Comment: 13 pages, TeX, Uses Harvmac (big). Improved R-parity discussion (v2). Redundant singlet excised (v3). Figure added and minor corrections, added references (v4

Systematic review of physical activity and exercise interventions to improve health, fitness and well-being of children and young people who use wheelchairs.

AIM: To perform a systematic review establishing the current evidence base for physical activity and exercise interventions that promote health, fitness and well-being, rather than specific functional improvements, for children who use wheelchairs. DESIGN: A systematic review using a mixed methods design. DATA SOURCES: A wide range of databases, including Web of Science, PubMed, BMJ Best Practice, NHS EED, CINAHL, AMED, NICAN, PsychINFO, were searched for quantitative, qualitative and health economics evidence. ELIGIBILITY: participants: children/young people aged >25 years who use a wheelchair, or parents and therapists/carers. Intervention: home-based or community-based physical activity to improve health, fitness and well-being. RESULTS: Thirty quantitative studies that measured indicators of health, fitness and well-being and one qualitative study were included. Studies were very heterogeneous preventing a meta-analysis, and the risk of bias was generally high. Most studies focused on children with cerebral palsy and used an outcome measure of walking or standing, indicating that they were generally designed for children with already good motor function and mobility. Improvements in health, fitness and well-being were found across the range of outcome types. There were no reports of negative changes. No economics evidence was found. CONCLUSIONS: It was found that children who use wheelchairs can participate in physical activity interventions safely. The paucity of robust studies evaluating interventions to improve health and fitness is concerning. This hinders adequate policymaking and guidance for practitioners, and requires urgent attention. However, the evidence that does exist suggests that children who use wheelchairs are able to experience the positive benefits associated with appropriately designed exercise. TRIAL REGISTRATION NUMBER: CRD42013003939

Phenomenology of flavor-mediated supersymmetry breaking

The phenomenology of a new economical SUSY model that utilizes dynamical SUSY breaking and gauge-mediation (GM) for the generation of the sparticle spectrum and the hierarchy of fermion masses is discussed. Similarities between the communication of SUSY breaking through a messenger sector, and the generation of flavor using the Froggatt-Nielsen (FN) mechanism are exploited, leading to the identification of vector-like messenger fields with FN fields, and the messenger U(1) as a flavor symmetry. An immediate consequence is that the first and second generation scalars acquire flavor-dependent masses, but do not violate FCNC bounds since their mass scale, consistent with effective SUSY, is of order 10 TeV. We define and advocate a minimal flavor-mediated model (MFMM), recently introduced in the literature, that successfully accommodates the small flavor-breaking parameters of the standard model using order one couplings and ratios of flavon field vevs. The mediation of SUSY breaking occurs via two-loop log-enhanced GM contributions, as well as several one-loop and two-loop Yukawa-mediated contributions for which we provide analytical expressions. The MFMM is parameterized by a small set of masses and couplings, with values restricted by several model constraints and experimental data. The next-to-lightest sparticle (NLSP) always has a decay length that is larger than the scale of a detector, and is either the lightest stau or the lightest neutralino. Similar to ordinary GM models, the best collider search strategies are, respectively, inclusive production of at least one highly ionizing track, or events with many taus plus missing energy. In addition, D^0 - \bar{D}^0 mixing is also a generic low energy signal. Finally, the dynamical generation of the neutrino masses is briefly discussed.Comment: 54 pages, LaTeX, 8 figure

Physics searches at the LHC

With the LHC up and running, the focus of experimental and theoretical high energy physics will soon turn to an interpretation of LHC data in terms of the physics of electroweak symmetry breaking and the TeV scale. We present here a broad review of models for new TeV-scale physics and their LHC signatures. In addition, we discuss possible new physics signatures and describe how they can be linked to specific models of physics beyond the Standard Model. Finally, we illustrate how the LHC era could culminate in a detailed understanding of the underlying principles of TeV-scale physics.Comment: 184 pages, 55 figures, 14 tables, hundreds of references; scientific feedback is welcome and encouraged. v2: text, references and Overview Table added; feedback still welcom

Reliability of maximal isometric knee strength testing with modified hand-held dynamometry in patients awaiting total knee arthroplasty: useful in research and individual patient settings? A reliability study

<p>Abstract</p> <p><b>Background</b></p> <p>Patients undergoing total knee arthroplasty (TKA) often experience strength deficits both pre- and post-operatively. As these deficits may have a direct impact on functional recovery, strength assessment should be performed in this patient population. For these assessments, reliable measurements should be used. This study aimed to determine the inter- and intrarater reliability of hand-held dynamometry (HHD) in measuring isometric knee strength in patients awaiting TKA.</p> <p><b>Methods</b></p> <p>To determine interrater reliability, 32 patients (81.3% female) were assessed by two examiners. Patients were assessed consecutively by both examiners on the same individual test dates. To determine intrarater reliability, a subgroup (n = 13) was again assessed by the examiners within four weeks of the initial testing procedure. Maximal isometric knee flexor and extensor strength were tested using a modified Citec hand-held dynamometer. Both the affected and unaffected knee were tested. Reliability was assessed using the Intraclass Correlation Coefficient (ICC). In addition, the Standard Error of Measurement (SEM) and the Smallest Detectable Difference (SDD) were used to determine reliability.</p> <p><b>Results</b></p> <p>In both the affected and unaffected knee, the inter- and intrarater reliability were good for knee flexors (ICC range 0.76-0.94) and excellent for knee extensors (ICC range 0.92-0.97). However, measurement error was high, displaying SDD ranges between 21.7% and 36.2% for interrater reliability and between 19.0% and 57.5% for intrarater reliability. Overall, measurement error was higher for the knee flexors than for the knee extensors.</p> <p><b>Conclusions</b></p> <p>Modified HHD appears to be a reliable strength measure, producing good to excellent ICC values for both inter- and intrarater reliability in a group of TKA patients. High SEM and SDD values, however, indicate high measurement error for individual measures. This study demonstrates that a modified HHD is appropriate to evaluate knee strength changes in TKA patient groups. However, it also demonstrates that modified HHD is not suitable to measure individual strength changes. The use of modified HHD is, therefore, not advised for use in a clinical setting.</p

Physical fitness training for stroke patients

Fitness training is considered beneficial for stroke patients. Physical fitness is important for the performance of everyday activities. The physical fitness of stroke patients is impaired after their stroke and this may reduce their ability to perform everyday activities and also exacerbate any stroke-related disability. This review of 32 trials involving 1414 participants found that cardiorespiratory fitness training after stroke can improve walking performance. There are too few data for other reliable conclusions to be drawn

A Systematic Review of Dynamometry and its Role in Hand Trauma Assessment

The dynamometer was developed by American neurologists and came into general use in the late 19th century. It is still used in various ways as a diagnostic and prognostic tool in clinical settings. In this systematic review we assessed in detail the different uses of dynamometry, its reliability, different dynamometers used and the influence of rater experience by bringing together and evaluating all published literature in this field. It was found that dynamometry is applied in a wide range of medical conditions. Furthermore, the great majority of studies reported acceptable to high reliability of dynamometry. Jamar mechanical dynamometer was used most often in the studies reviewed. There were mixed results concerning the effect of rater experience. The factors influencing the results of dynamometry were identified as age, gender, body weight, grip strength, BMI, non/dominant hand, assessing upper/lower limbs, rater and patient’s strength and the distance from the joint where the dynamometer is placed. This review provides an understanding of the relevance and significance of dynamometry which should serve as a starting point to guide its use in hand trauma assessment. On the basis of our findings, we suggest that hand dynamometry has a great potential, and could be used more often in clinical practice