Service Quality In Accounting Firms: The Relationship Of Service Quality To Client Satisfaction And Firm/Client Conflict

This paper presents the results of a study using the marketing-based SERVQUAL scale to examine the relationship between service quality and both client satisfaction and firm/client conflict in an accounting firm setting.  Using a sample of 154 clients, we confirm that service quality is positively related to clients’ satisfaction with their accounting firm and negatively related to firm/client conflict.  We also examine the individual dimensions of service quality to provide insight into specific steps accounting firms can take both to increase client satisfaction and to decrease firm/client conflict

The Relationship Of Service Quality To Client Satisfaction In An Accounting Firm Setting

This paper presents the results of a study using the marketing-based SERVQUAL scale to examine the relationship between service quality and client satisfaction in an accounting firm setting.  Using a sample of 154 clients, we confirm that service quality is positively related in clients’ satisfaction with their accounting firm.  More importantly, we examine the individual dimensions of service quality to provide insight into specific steps accounting firms can take to increase client satisfaction

The Impact Of Communication On The Accounting Firm/Client Relationship

This paper presents the results of a study designed to gather information on communication between an accounting firm and its clients.  We first provide descriptive information on clients’ perceptions regarding the frequency, method, and importance of communication with their accounting firm.  We then provide evidence on the relationship between effective communication and both client satisfaction and accounting firm/client conflict.  We find that that the use of effective communication techniques by an accounting firm is positively related to client satisfaction and negatively related to firm/client conflict.  The overall results of this study suggest that accounting firms can effectively use collaborative communication, which focuses on using communication to build better relationships between firms, to manage client relations

Biofeedback for gait retraining based on real-time estimation of tibiofemoral joint contact forces

Biofeedback assisted rehabilitation and intervention technologies have the potential to modify clinically relevant biomechanics. Gait retraining has been used to reduce the knee adduction moment, a surrogate of medial tibiofemoral joint loading often used in knee osteoarthritis research. In this study we present an electromyogram-driven neuromusculoskeletal model of the lower-limb to estimate, in real-time, the tibiofemoral joint loads. The model included 34 musculotendon units spanning the hip, knee, and ankle joints. Full-body inverse kinematics, inverse dynamics, and musculotendon kinematics were solved in real-time from motion capture and force plate data to estimate the knee medial tibiofemoral contact force (MTFF). We analyzed 5 healthy subjects while they were walking on an instrumented treadmill with visual biofeedback of their MTFF. Each subject was asked to modify their gait in order to vary the magnitude of their MTFF. All subjects were able to increase their MTFF, whereas only 3 subjects could decrease it, and only after receiving verbal suggestions about possible gait modification strategies. Results indicate the important role of knee muscle activation patterns in modulating the MTFF. While this study focused on the knee, the technology can be extended to examine the musculoskeletal tissue loads at different sites of the human body

Biofeedback for gait retraining based on real-time estimation of tibiofemoral joint contact forces

Biofeedback assisted rehabilitation and intervention technologies have the potential to modify clinically relevant biomechanics. Gait retraining has been used to reduce the knee adduction moment, a surrogate of medial tibiofemoral joint loading often used in knee osteoarthritis research. In this study we present an electromyogram-driven neuromusculoskeletal model of the lower-limb to estimate, in real-time, the tibiofemoral joint loads. The model included 34 musculotendon units spanning the hip, knee, and ankle joints. Full-body inverse kinematics, inverse dynamics, and musculotendon kinematics were solved in real-time from motion capture and force plate data to estimate the knee medial tibiofemoral contact force (MTFF). We analyzed 5 healthy subjects while they were walking on an instrumented treadmill with visual biofeedback of their MTFF. Each subject was asked to modify their gait in order to vary the magnitude of their MTFF. All subjects were able to increase their MTFF, whereas only 3 subjects could decrease it, and only after receiving verbal suggestions about possible gait modification strategies. Results indicate the important role of knee muscle activation patterns in modulating the MTFF. While this study focused on the knee, the technology can be extended to examine the musculoskeletal tissue loads at different sites of the human body

Tibiofemoral Contact Forces in the Anterior Cruciate Ligament-Reconstructed Knee.

PURPOSE: To investigate differences in ACL reconstructed (ACLR) and healthy individuals in terms of the magnitude of the tibiofemoral contact forces, as well as the relative muscle and external load contributions to those contact forces, during walking, running and sidestepping gait tasks. METHODS: A computational electromyography-driven neuromusculoskeletal model was used to estimate the muscle and tibiofemoral contact forces in those with combined semitendinosus and gracilis tendon autograft ACLR (n=104, 29.7±6.5 years, 78.1±14.4 kg) and healthy controls (n=60, 27.5±5.4 years, 67.8±14.0 kg) during walking (1.4±0.2 ms), running (4.5±0.5 ms) and sidestepping (3.7±0.6 ms). Within the computational model, the semitendinosus of ACLR participants was adjusted to account for literature reported strength deficits and morphological changes subsequent to autograft harvesting. RESULTS: ACLRs had smaller maximum total and medial tibiofemoral contact forces (~80% of control values, scaled to bodyweight) during the different gait tasks. Compared to controls, ACLRs were found to have a smaller maximum knee flexion moment, which explained the smaller tibiofemoral contact forces. Similarly, compared to controls, ACLRs had both a smaller maximum knee flexion angle and knee flexion excursion during running and sidestepping, which may have concentrated the articular contact forces to smaller areas within the tibiofemoral joint. Mean relative muscle and external load contributions to the tibiofemoral contact forces were not significantly different between ACLRs and controls. CONCLUSION: ACLRs had lower bodyweight-scaled tibiofemoral contact forces during walking, running and sidestepping, likely due to lower knee flexion moments and straighter knee during the different gait tasks. The relative contributions of muscles and external loads to the contact forces were equivalent between groups

Tibiofemoral contact forces during walking, running and sidestepping

We explored the tibiofemoral contact forces and the relative contributions of muscles and external loads to those contact forces during various gait tasks. Second, we assessed the relationships between external gait measures and contact forces. A calibrated electromyography-driven neuromusculoskeletal model estimated the tibiofemoral contact forces during walking (1.44 ± 0.22 m s−1), running (4.38 ± 0.42 m s−1) and sidestepping (3.58 ± 0.50 m s−1) in healthy adults (n = 60, 27.3 ± 5.4 years, 1.75 ± 0.11 m, and 69.8 ± 14.0 kg). Contact forces increased from walking (∼1–2.8 BW) to running (∼3–8 BW), sidestepping had largest maximum total (8.47 ± 1.57 BW) and lateral contact forces (4.3 ± 1.05 BW), while running had largest maximum medial contact forces (5.1 ± 0.95 BW). Relative muscle contributions increased across gait tasks (up to 80–90% of medial contact forces), and peaked during running for lateral contact forces (∼90%). Knee adduction moment (KAM) had weak relationships with tibiofemoral contact forces (all R2 < 0.36) and the relationships were gait task-specific. Step-wise regression of multiple external gait measures strengthened relationships (0.20 < Radj2 < 0.78), but were variable across gait tasks. Step-wise regression equations from a particular gait task (e.g. walking) produced large errors when applied to a different gait task (e.g. running or sidestepping). Muscles well stabilized the knee, increasing their role in stabilization from walking to running to sidestepping. KAM was a poor predictor of medial contact force and load distributions. Step-wise regression models results suggest the relationships between external gait measures and contact forces cannot be generalized across tasks. Neuromusculoskeletal modelling may be required to examine tibiofemoral contact forces and role of muscle in knee stabilization across gait tasks