COGNITIVE FUNCTIONAL APPROACH TO MANAGE LOW BACK PAIN IN ROWERS

There is a high prevalence of low back pain in rowers at all training levels. However, very few studies have reported an effective management strategy to reduce low back pain in these athletes. This may be due to the multidimensional nature of low back pain that ranges from physical, psychological, social and lifestyle factors. Recently, a Cognitive Functional approach to manage low back pain has been shown to reduce low back pain and disability in adolescent male rowers. This management strategy has been adapted and implemented to prevent LBP in elite international level rowers

Investigation into the prevalence, spinal kinematics and management of adolescent male rowers with low back pain

This thesis investigated back pain in adolescent rowers. A high prevalence of low back pain was found in adolescent male rowers. Differences in lumbar spine movement patterns during ergometer rowing were observed between genders and in adolescent males with back pain compared to those without. A cognitive functional intervention was tested in a randomized controlled trial and was demonstrated to reduce pain and disability, improve muscle endurance and alter sitting spinal postures in adolescent male rowers

Using autoregressive integrated moving average (ARIMA) models to predict and monitor the number of beds occupied during a SARS outbreak in a tertiary hospital in Singapore.

BACKGROUND: The main objective of this study is to apply autoregressive integrated moving average (ARIMA) models to make real-time predictions on the number of beds occupied in Tan Tock Seng Hospital, during the recent SARS outbreak. METHODS: This is a retrospective study design. Hospital admission and occupancy data for isolation beds was collected from Tan Tock Seng hospital for the period 14th March 2003 to 31st May 2003. The main outcome measure was daily number of isolation beds occupied by SARS patients. Among the covariates considered were daily number of people screened, daily number of people admitted (including observation, suspect and probable cases) and days from the most recent significant event discovery. We utilized the following strategy for the analysis. Firstly, we split the outbreak data into two. Data from 14th March to 21st April 2003 was used for model development. We used structural ARIMA models in an attempt to model the number of beds occupied. Estimation is via the maximum likelihood method using the Kalman filter. For the ARIMA model parameters, we considered the simplest parsimonious lowest order model. RESULTS: We found that the ARIMA (1,0,3) model was able to describe and predict the number of beds occupied during the SARS outbreak well. The mean absolute percentage error (MAPE) for the training set and validation set were 5.7% and 8.6% respectively, which we found was reasonable for use in the hospital setting. Furthermore, the model also provided three-day forecasts of the number of beds required. Total number of admissions and probable cases admitted on the previous day were also found to be independent prognostic factors of bed occupancy. CONCLUSION: ARIMA models provide useful tools for administrators and clinicians in planning for real-time bed capacity during an outbreak of an infectious disease such as SARS. The model could well be used in planning for bed-capacity during outbreaks of other infectious diseases as well

The Assessment of Physiotherapy Practice tool provides informative assessments of clinical and professional dimensions of student performance in undergraduate placements: a longitudinal validity and reliability study

© 2020 Australian Physiotherapy Association Questions: Do one or two factors best represent clinical performance scores obtained via the Assessment of Physiotherapy Practice (APP) and what is the nature of their characterisation? To what extent are the same number of factors and their interpretation, and item scaling captured equally over time and across contexts (eg, clinical subdisciplines) for assessments of clinical performance via the APP? Design: Archival and longitudinal study of undergraduate students’ clinical performances for each of four final-year clinical placements. Participants: A total of 561 undergraduate physiotherapy students from one Australian university who were enrolled to complete their final-year clinical placements between 2014 and 2017. Outcome measures: Clinical educators’ assessments of student performance across seven key domains of clinical practice: professional behaviour, communication, assessment, analysis and planning, intervention, evidence-based practice and risk management. Results: Factor analyses supported the superiority of a two-factor representation of the APP, including dimensions characterised by professional and clinical domains, when compared with a unidimensional structure of an overarching ‘clinical performance’ factor. It was also found that the two-factor representation and item scaling was consistent across four clinical placements covering typical areas of physiotherapy practice. In other words, the same constructs are being assessed equally well across context and time. Conclusions: The APP is the nationally adopted assessment tool that is used to evaluate clinical competence to practise as a physiotherapist in Australia and New Zealand. These findings provide new evidence for an updated scoring protocol in which clinical factors are distinguished from professional competencies

GENDER DIFFERENCES IN MOTOR CONTROL OF THE TRUNK DURING PROLONGED ERGOMETER ROWING

The aim of the study was to compare the temporal kinematics of a stroke, spino-pelvic kinematics, trunk and quadriceps muscle activation in prolonged ergometer rowing between males and female rowers. Twelve adolescent rowers performed a 20 minute rowing ergometer trial at a high self perceived rate of exertion. Spino-pelvic kinematics, muscle activity and temporal kinematics data were compared in the 1st, 10th and 20th minute. The results from this study indicate there is a difference in temporal kinematics of a rowing stroke between adolescent males and females. Furthermore, males row with a more flexed thoracic spine and a posteriorly rotated sacrum compared to females at the catch and the finish positions

Multifidelity approaches for optimization under uncertainty

It is important to design robust and reliable systems by accounting for uncertainty and variability in the design process. However, performing optimization in this setting can be computationally expensive, requiring many evaluations of the numerical model to compute statistics of the system performance at every optimization iteration. This paper proposes a multifidelity approach to optimization under uncertainty that makes use of inexpensive, low-fidelity models to provide approximate information about the expensive, high-fidelity model. The multifidelity estimator is developed based on the control variate method to reduce the computational cost of achieving a specified mean square error in the statistic estimate. The method optimally allocates the computational load between the two models based on their relative evaluation cost and the strength of the correlation between them. This paper also develops an information reuse estimator that exploits the autocorrelation structure of the high-fidelity model in the design space to reduce the cost of repeatedly estimating statistics during the course of optimization. Finally, a combined estimator incorporates the features of both the multifidelity estimator and the information reuse estimator. The methods demonstrate 90% computational savings in an acoustic horn robust optimization example and practical design turnaround time in a robust wing optimization problem.United States. Air Force Office of Scientific Research. Multidisciplinary University Research Initiative (Uncertainty Quantification Grant FA9550-09-0613

An Ecological Dynamics Approach for Movement Assessment

Ecological dynamics has gained increasing acceptance as a theoretical framework in the field of motor development. This framework underpins this research programme, which postulates that humans are open, complex systems and that observed movements are self-organised movement responses. Importantly, movement responses are dependent upon the dynamic interaction between constraints and the calibration between action-capabilities and available affordances. Developing movement competence in children is especially critical for the associated links with physical, emotional and mental health. Thus, monitoring competence levels remains a vital prerogative of the scientific community, governments and various agencies the world over. Movement competence is assessed and monitored using movement assessment batteries. Many movement assessments used today were initially developed for clinical populations. Thus, concern has been raised in the literature with its increased use for the general population of typically developing children. Specifically, concerns surround assessment tasks being too closely associated with sport-specific skills, assessment tasks being overly simplified and decontextualised. Moreover, many movement assessment batteries do not accommodate individuals from demonstrating adaptive movement responses to achieve outcome goals. Consequently, results from these assessments, may not adequately describe an individual’s general movement competence. This programme of work set out to develop a new movement assessment tool (General Movement Competence Assessment or GMCA) and proposes a theoretically-driven definition of movement competence. The GMCA utilises sensor-less, motion-tracking technology. It consists of five customised active video games that consider the critical role that affordances play in movement responses. The primary aim of this thesis was to establish the GMCA’s validity and reliability for use as a potential tool for assessing general movement competence. Three related studies examined the various aspects of the GMCA’s reliability, validity and sensitivity in detecting developmental changes. Study 1 examined the factorial-structure of the newly developed GMCA. The extracted factors from the exploratory factor analysis accounted for 69.4% of the variance. Study 2 tested the construct validity of the extracted model and examined correlations between GMCA performance and age. The last study, study 3, examined the responsiveness or sensitivity of the GMCA in detecting developmental changes. Collectively, results from the three empirical studies suggest that the GMCA is a valid tool that is capable of assessing, detecting and monitoring developmental changes. This thesis has contributed novel knowledge to the field of motor development by demonstrating the potential of video game technology in the assessment of movement competence. Importantly, dexterity was established as a new independent construct in the model of movement competence. The programmability of the GMCA favours its potential as a teaching tool in motor learning and its presentation via a series of active video games is a progressive step towards the provision of dynamic assessment tasks. Video games are typically cast in a negative light by society in the face of decreasing levels of physical activity. Conversely, findings from this programme of work illustrate the feasibility of video game technology as a viable option for assessing movement competence and this emerging technology could help to turn the tide of physical inactivity amongst children

Spinal Kinematics of Adolescent Male Rowers With Back Pain in Comparison to Matched Controls During Ergometer Rowing.

There is a high prevalence of low back pain (LBP) in adolescent male rowers. In this study, regional lumbar spinal kinematics and self-reported LBP intensity were compared between 10 adolescent rowers with moderate levels of LBP relating to rowing with 10 reporting no history of LBP during a 15-minute ergometer trial using an electromagnetic tracking system. Adolescent male rowers with LBP reported increasing pain intensity during ergometer rowing. No significant differences were detected in mean upper or lower lumbar angles between rowers with and without LBP. However, compared to rowers without pain, rowers with pain had: 1) relatively less excursion of the upper lumbar spine into extension over the drive phase, 2) relatively less excursion of the lower lumbar spine into extension over time, 3) greater variability in upper and lower lumbar angles over the 15-minute ergometer trial, 4) positioned their upper lumbar spine closer to end range flexion for a greater proportion of the drive phase, and 5) showed increased time in sustained flexion loading in the upper lumbar spine. Differences in regional lumbar kinematics exist between adolescent male rowers with and without LBP, which may have injury implication and intervention strategies

Multidelity approaches for design under uncertainty

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Aeronautics and Astronautics, 2013.This electronic version was submitted and approved by the author's academic department as part of an electronic thesis pilot project. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from department-submitted PDF version of thesis.Includes bibliographical references (p. 113-117).Uncertainties are present in many engineering applications and it is important to account for their effects during engineering design to achieve robust and reliable systems. One approach is to represent uncertainties as random inputs to the numerical model of the system and investigate the probabilistic behaviour of the model outputs. However, performing optimization in this setting can be computationally expensive, requiring many evaluations of the numerical model to compute the statistics of the system metrics, such as the mean and the variance of the system performance. Fortunately, in many engineering applications, there are one or more lower fidelity models that approximate the original (high-fidelity) numerical model at lower computational costs. This thesis presents rigorous multifidelity approaches to leverage cheap low-fidelity models and other approximations of the expensive high-fidelity model to reduce the computational expense of optimization under uncertainty. Solving an optimization under uncertainty problem can require estimates of the statistics at many different design points, incurring a significant number of expensive high-fidelity model evaluations. The multifidelity estimator is developed based on the control variate method to reduce the computational cost of achieving a specified root mean square error in the statistic estimate by making use of the correlation between the outputs of the expensive high-fidelity model and the outputs of the cheap low-fidelity model. The method optimally relegates some of the computational load to the low-fidelity model based on the relative model evaluation cost and the strength of the correlation. It has demonstrated 85% computational savings in an acoustic horn robust optimization example. When the model is sufficiently smooth in the design space in the sense that a small change in the design variables produces a small change in the model outputs, it has an autocorrelation structure that can be exploited by the control variate method. The information reuse estimator is developed to reduce the computational cost of achieving a specified root mean square error in the statistic estimate by making use of the correlation between the high-fidelity model outputs at one design point and those at a previously visited design point. As the optimization progresses towards the optimum in the design space, the steps taken in the design space often become shorter, increasing the correlation and making the information reuse estimator more efficient. To further reduce the computational cost, the combined estimator is developed to incorporate the features of both the multifidelity estimator and the information reuse estimator. It has demonstrated 90% computational savings in the acoustic horn robust optimization example. The methods developed in this thesis are applied to two practical aerospace applications. In conceptual aircraft design, there are often uncertainties about the future developments of the underlying technologies. The information reuse estimator can be used to efficiently generate a Pareto front to study the trade off between the expected performance and the risk induced by the uncertainties in the different aircraft designs. In a large-scale wing robust optimization problem with uncertainties in material properties and flight conditions, the combined estimator demonstrated a reasonable solution turnaround time of 9.7 days on a 16-processor desktop machine, paving the way to a larger scale wing optimization problem with distributed uncertainties to account for degradation or damage.by Leo Wai-Tsun Ng.Ph.D