Test-retest reliability of physiotherapists using the action research arm test in chronic stroke

Purpose: The aim of this study was to determine whether physiotherapists (PT) scores are consistent over time when using Action Research Arm Test (ARAT) to assess upper limb (UL) function on a videotaped chronic stroke patient. Subjects and Methods: Quantitative correlational study. A convenience-snowball sample of 20 international PT (mean age and experience = 32 ± 6.8 and 7.55 ± 7.4 years) used ARAT to score chronic stroke patient’s UL function, observing a video at baseline and again ≈ 2 weeks later. Two sets of non-parametric ordinal data were assessed with Spearman’s (rho) and the alpha (a) value was set at 0.01. Line of equality, Bland-Altman plots and Wilcoxon signed rank test were also considered. Results: Spearman’s rho was found ≈ 0.78 at a significance level of 0.00. ARAT was scored with a mean difference of 16.6 days and a mean change of 0.6 points was observed. Limits of agreement and coefficient of reproducibility were ±2.3 and ±2.6 respectively. The patient’s arm impairment was categorised as moderate and floor or ceiling effects were not detected. Conclusion: The results suggest that ARAT is consistent, valid and should be used by PT in chronic stroke.<br/

Efficacy of mirror therapy on lower limb motor recovery, balance and gait in subacute and chronic stroke: a systematic review

ObjectiveMirror therapy (MT) has been proposed to be an effective therapeutic regimen for lower limb stroke rehabilitation. This review is the first to evaluate the efficacy of MT in subacute and chronic stroke for lower-limb motor functions, balance and gait focusing on particular stage of stroke with specific outcome measures.MethodsAccording to PRISMA guidelines, all relevant sources were searched from 2005 to 2020 using “PIOD” framework. Search methods included electronic database, hand and citation searching. Screening and quality assessment was performed by two individual reviewers. Data was extracted and synthesised from 10 studies. Thematic analysis was considered, random-effect models were used and pooled analysis was performed using forest plots.ResultsFor motor recovery, MT showed statistically significant effects compared to control group using Fugl-Meyer Assessment and Brunnstorm stages as outcome measures (SMD 0.59; 95% CI 0.29 to 0.88; p < 0.0001; I2 = 0%). Statistical significant improvement was reported for balance in MT compared to control using Berg Balance Scale and Biodex in pooled analysis (SMD 0.47; 95% CI 0.04 to 0.90; p = 0.03; I2 = 0%). When compared with electric stimulation and action-observation training MT showed no signifiant improvement for balance (SMD −0.21; 95% CI −0.91 to 0.50; p = 0.56; I2 = 39%). For gait, MT showed statistical and clinical significant improvement compared to control group (SMD 1.13; 95% CI 0.27–2.00; p = 0.01; I2 = 84%) and when compared to action-observation training and electrical stimulation, presented statistical improvement using 10-m walk test and Motion Capture system (SMD −0.65; 95% CI −1.15 to −0.15; p = 0.01; I2 = 0%).ConclusionThis review has shown that MT is effective in lower-limb motor recovery, balance and gait in subacute and chronic stroke in patients 18 years or above with no severe cognitive disorder, MMSE score ≥24 and FAC level ≥2. MT could be used for 30 min/day, 5 days/week for 4 weeks, as stand-alone for motor recovery and balance or as an adjunct with electric stimulation for gait for beneficial effects

Solar powered biohydrogen production requires specific localization of the hydrogenase

This work was supported by BBSRC Grant (BB/G021856/1) to SJB, PJN and CWM. We acknowledge support from the U.S. DoE, Biological and Environmental Research Program to MB, the U.S. DoE Fuel Cell Technologies Office (contract number DE-AC36-08-GO28308) to CAE and EPSRC (EP/F00270X/1) to MB and PJN

Inter-rater reliability of physiotherapists using the Action Research Arm Test in chronic stroke

The purpose of this study is to establish whether physiotherapists' ratings are consistent, when using the Action Research Arm Test (ARAT) to score a chronic stroke patient. This was part of a large project establishing the reliability in chronic stroke. This study used a correlational design comparing the association between physiotherapist scores of the same patient, to establish the ARAT's inter-rater reliability. The COSMIN checklist was followed to enhance the methodology of the study. Twenty physiotherapists (8 female and 12 male) aged between 25 and 53 years were selected. There were no participant dropouts or withdrawals. The sample size was normally distributed. The physiotherapists appeared representative of the UK physiotherapy population, with the exception of gender. The distribution of scores showed a normal distribution with standard deviation of score of 1.9. The Kendall's W test showed 0.711 of agreement between the raters. The scores achieved statistical significance showing consistency between physiotherapists' scores with chronic stroke. Limitations of the study were the use of a small single center convenience sample that may reduce the generalizability of the findings. The ARAT is consistent when scored by physiotherapists in a chronic stroke population. The inter-rater reliability range was (0.70 to 0.90) which is categorized as good

Effect of hip abductors and lateral rotators' muscle strengthening on pain and functional outcome in adult patients with patellofemoral pain: a systematic review and meta-analysis

Even though literature indicates presence of weak hip abductors and lateral rotators' in Patellofemoral Pain (PFP), studies evaluating the effect of hip abductors and lateral rotator strengthening to improve knee function and quality of life in PFP are limited. This study systematically reviews and meta-analyzes the best evidence on the therapeutic value of strengthening hip abductors and lateral rotators muscles for treating PFP with a presumptive hypothesis that strengthening hip muscles stabilizes the patellofemoral joint, relieves pain, and enhances knee functions. Medline, EMBASE, CINAHL, PEDro and PubMed Central databases were searched between January 1994 and September 2019 using the PICOS tool. The methodological quality of the selected studies were appraised individually using the 20-item McMaster Critical Review Form for Quantitative Studies. Supplemental quality appraisal of randomized controlled clinical trials performed using the Cochrane Collaboration's 'Risk of bias' quality criteria. Data on patient population demographics, interventions, duration of intervention, and outcome measures were extracted and summarized in evidence tables and descriptive analysis. Meta-analyses under both fixed and random-effects models determined pooled effects size from appropriate RCTs. All fourteen studies demonstrated that hip muscle strengthening improved pain and knee function. All RCTs, except one, demonstrated that hip muscle strengthening is superior to quadriceps strengthening. Of the five RCTs accessing the additional effect of hip-quad versus quadriceps strengthening, four suggested that hip-quad strengthening is superior to standard quadriceps strengthening alone to improve PFP and knee function. In adult patients with PFP, strengthening hip abductors and lateral rotators' have beneficial therapeutic effects than the conventional quadriceps exercises in improving knee pain and function both in the short- and long term. However, the present review data can be used to develop a standardized hip-quad protocol in the future

Tellurium, magmatic fluids and orogenic gold: An early magmatic fluid pulse at Cononish gold deposit, Scotland

Significant tellurium enrichment occurs in many orogenic gold deposits but the factors causing this are little understood; some authors suggest this demands a magmatic input whereas others suggest it need not. Fractionation of Te from Se and S could offer insight into source/pathway processes of auriferous fluids. The metasedimentary-hosted Cononish vein gold deposit, Scotland, is unusually Te-rich compared to many orogenic gold deposits with Te/Au ≈ 2.4 whereas most orogenic deposits have Te/Au < 1. Here, Ag in Au-Ag alloy increases from ∼10 to 90 wt% through the paragenesis, correlating with decreasing hessite (Ag2Te) abundance. This suggests the Au-Ag alloy composition was controlled by the fluid Te activity, and that this decreased through time. This is coupled to an increase in pyrite δ34S from −2.0‰ to +11.4‰ through the paragenesis. Thus, the deposit formed from a primary fluid with a low-δ34S and high Te + Au + Ag that evolved to a high δ34S-low Te, Pb + Cu bearing fluid. The high δ34S of the later fluid suggests it can only be sourced from specific nearby metamorphosed SEDEX horizons. The early fluid that deposited most of the gold could be sourced from other metasedimentary units in the stratigraphy or be magmatic in origin. We argue that two observations taken together suggest it is most likely that this fluid was magmatic; the age of the mineralisation is identical to the last stage of crystallization of nearby granite batholiths, and the fluid has a S-isotope signature consistent with a magmatic source. Gold deposits in orogenic belts are almost certainly polygenetic and this study demonstrates evidence for Te-rich “orogenic” deposits having a significant magmatic component

Food color is in the eye of the beholder: the role of human trichromatic vision in food evaluation

Non-human primates evaluate food quality based on brightness of red and green shades of color, with red signaling higher energy or greater protein content in fruits and leafs. Despite the strong association between food and other sensory modalities, humans, too, estimate critical food features, such as calorie content, from vision. Previous research primarily focused on the effects of color on taste/flavor identification and intensity judgments. However, whether evaluation of perceived calorie content and arousal in humans are biased by color has received comparatively less attention. In this study we showed that color content of food images predicts arousal and perceived calorie content reported when viewing food even when confounding variables were controlled for. Specifically, arousal positively co-varied with red-brightness, while green-brightness was negatively associated with arousal and perceived calorie content. This result holds for a large array of food comprising of natural food - where color likely predicts calorie content - and of transformed food where, instead, color is poorly diagnostic of energy content. Importantly, this pattern does not emerged with nonfood items. We conclude that in humans visual inspection of food is central to its evaluation and seems to partially engage the same basic system as non-human primates

Consumer perceptions of co-branding alliances: Organizational dissimilarity signals and brand fit

This study explores how consumers evaluate co-branding alliances between dissimilar partner firms. Customers are well aware that different firms are behind a co-branded product and observe the partner firms’ characteristics. Drawing on signaling theory, we assert that consumers use organizational characteristics as signals in their assessment of brand fit and for their purchasing decisions. Some organizational signals are beyond the control of the co-branding partners or at least they cannot alter them on short notice. We use a quasi-experimental design and test how co-branding partner dissimilarity affects brand fit perception. The results show that co-branding partner dissimilarity in terms of firm size, industry scope, and country-of-origin image negatively affects brand fit perception. Firm age dissimilarity does not exert significant influence. Because brand fit generally fosters a benevolent consumer attitude towards a co-branding alliance, the findings suggest that high partner dissimilarity may reduce overall co-branding alliance performance