The Effect of 3D Human Anatomy Software on Online Students’ Academic Performance

Understanding anatomy is vital to occupational therapy (OT) for clinical success. Anatomy requires comprehending three-dimensional (3D) human structure relationships and student age and learning style differences may affect this understanding. This study examined how 3D anatomy software influenced online OT students’ grades among different ages and learning styles. The intervention group had 17 students (mean age 33 ± 8 years) and the control group had 18 students (mean age 32 ± 6 years). Students were categorized above or below the age of 30 and completed a learning style questionnaire at the beginning of the course. To determine the usefulness of the software, the intervention group completed a custom-survey. Independent sample t-tests were used to compare grades between the intervention and control groups. Non-parametric tests were used to compare grades of different ages and learning style groups. The intervention group had higher overall final course grades when compared to the control group, although not statistically significant (p\u3e0.05). Additionally, lecture and laboratory grades were not higher (p\u3e0.05). Most students (82%) reported the use of the anatomy software to be helpful in understanding course concepts. No statistically significant course grade differences were found among the different learning styles or two age groups (p\u3e0.05). In conclusion, intervention group final course grades were higher and the software benefitted all learning styles and both age groups. Thus, OT programs should consider using 3D anatomy software programs to aid in foundational anatomy education

The Relationship of Spasticity and Impairments in Force Regulation and Neuromuscular Fatigue Post Stroke

Hyperreflexia that causes muscle spasticity may contribute to limitations in force regulation and walking ability post stroke. Additionally, neuromuscular fatigue may reduce force regulation, which is important because fatigue can assist to strengthen muscles that control walking. Hyperreflexia may be caused by cortical disinhibition that allows Ia afferents to amplify excitatory synaptic inputs to motoneuron pools. Cortical disinhibition is presumably caused by stroke-related motor cortex damage. Although, other excitatory synaptic sources to motoneurons contribute to motor control, hyperreflexia may be one contributor that affects stroke survivors. However, hyperreflexia is reported infrequently to effect force regulation post stroke. The goal was to quantify stroke related hyperreflexia with (out) a fatiguing condition and relate the findings to clinical function. To investigate how hyperreflexia affected force regulation in a non-fatiguing condition, stimulus frequency was examined in the soleus H-reflex response of stroke survivors and healthy controls. The H-reflex is an electrical analog of the stretch reflex and gives insight into the monosynaptic sensory pathway. After repetitive stimulation, stroke survivors had less H-reflex depression as compared to controls. Additionally, the slowest walking stroke survivors had less H-reflex depression. These results may indicate hyperreflexia contributes to rate depression and walking speed post stroke. Further implications on how hyperreflexia affected force regulation were investigated with patellar tendon tap (TT) responses during a fatiguing knee extensor task in stroke survivors and healthy controls. Additionally, the contributions of voluntary muscle strength, neural drive and involuntary muscle property responses were probed. Central mechanisms may primarily affect force regulation after fatigue because stroke survivors had less muscle property and maximal voluntary contraction reductions, along with greater voluntary activation reduction as compared to controls. Likewise, stroke survivors had higher post TT responses and less TT change after fatigue, which may suggest hyperreflexia with paresis may contribute to decreased force regulation. Additionally, stroke survivors with fewer baseline central impairments had less clinical dysfunctions. Hyperreflexia and impairments in the nervous system may decrease force regulation post stroke. Moreover, quantitative metrics of neuromuscular impairments may relate to clinical function measures, which may reveal central mechanisms need to be treated to improve force regulation

Is Compressed and Limited Synchronous Delivery of Anatomy Content in a Hybrid Delivery Format Effective in Transitional OT Student Learning?

Hybrid occupational therapy (OT) students transitioning from certified OT assistants (COTAs) to OTs can successfully learn graduate-level anatomy in a compressed format with limited synchronous instruction time. The effectiveness of a human anatomy course with limited synchronous instruction time for transitional hybrid occupational therapy students was investigated. A retrospective, non-randomized study was used. A university graduate level human anatomy course for transitional OT students used prosected (previously dissected) cadavers. Students (n=46, 32 instruction hours over 16 weeks) final anatomy course grades for three cohorts were measured retrospectively. There was a 98% first-time pass rate and 100% second time pass rate. Less than 5% of the students needed to either repeat the course (one student) or withdrew from the course prior to course completion (one student). Results suggest that a hybrid learning model with limited synchronous instruction time is effective for transitional OT students learning human anatomy. Programs should consider how instruction time and distribution impacts anatomy learners, and when there is limited time in the classroom, investigate alternative pedagogies for those few students who would benefit from a more immersive-learning environment. Anatomy knowledge is essential in progressing through occupational therapy curriculums and is needed for client management. Understanding what factors impact learning anatomy could assist in creating more effective anatomy courses for occupational therapy students

The Stroke-related Effects of Hip Flexion Fatigue on Over Ground Walking

Individuals post stroke often rely more on hip flexors for limb advancement during walking due to distal weakness but the effects of muscle fatigue in this group is not known. The purpose of this study was to quantify how stroke affects the influence of hip flexor fatigue on over ground walking kinematics and performance and muscle activation. Ten individuals with chronic stroke and 10 without stroke (controls) participated in the study. Maximal walking speed, walking distance, muscle electromyograms (EMG), and lower extremity joint kinematics were compared before and after dynamic, submaximal fatiguing contractions of the hip flexors (30% maximal load) performed until failure of the task. Task duration and decline in hip flexion maximal voluntary contraction (MVC) and power were used to assess fatigue. The stroke and control groups had similar task durations and percent reductions in MVC force following fatiguing contractions. Compared with controls, individuals with stroke had larger percent reductions in maximal walking speed, greater decrements in hip range of motion and peak velocity during swing, greater decrements in ankle velocity and lack of modulation of hip flexor EMG following fatiguing dynamic hip flexion contractions. For a given level of fatigue, the impact on walking function was more profound in individuals with stroke than neurologically intact individuals, and a decreased ability to up regulate hip flexor muscle activity may contribute. These data highlight the importance of monitoring the effect of hip flexor muscle activity during exercise or performance of activities of daily living on walking function post stroke

Impaired Regulation Post-stroke of Motor Unit Firing Behavior during Volitional Relaxation of Knee Extensor Torque Assessed Using High Density Surface EMG Decomposition

The purpose of this study was to use high density surface EMG recordings to quantify stroke-related abnormalities in motor unit firing behavior during repeated sub-maximal knee extensor contractions. A high density surface EMG system (sEMG) was used to record and extract single motor unit firing behavior in the vastus lateralis muscle of 6 individuals with chronic stroke and 8 controls during repeated sub-maximal isometric knee extension contractions. Paretic motor unit firing rates were increased with subsequent contractions (6.19±0.35 pps vs 7.89±0.66 pps,

Sex Differences in Neuromuscular Fatigability of the Knee Extensors Post-Stroke

Background and Purpose: Despite the implications of optimizing strength training post-stroke, little is known about the differences in fatigability between men and women with chronic stroke. The purpose of this study was to determine the sex differences in knee extensor muscle fatigability and potential mechanisms in individuals with stroke. Methods: Eighteen participants (10 men, eight women) with chronic stroke (≥6 months) and 23 (12 men, 11 women) nonstroke controls participated in the study. Participants performed an intermittent isometric contraction task (6 s contraction, 3 s rest) at 30% of maximal voluntary contraction (MVC) torque until failure to maintain the target torque. Electromyography was used to determine muscle activation and contractile properties were assessed with electrical stimulation of the quadriceps muscles. Results: Individuals with stroke had a briefer task duration (greater fatigability) than nonstroke individuals (24.1 ± 17 min vs. 34.9 ± 16 min). Men were more fatigable than women for both nonstroke controls and individuals with stroke (17.9 ± 9 min vs. 41.6 ± 15 min). Individuals with stroke had less fatigue-related changes in muscle contractile properties and women with stroke differed in their muscle activation strategy during the fatiguing contractions. Conclusions: Men and women fatigue differently post-stroke and this may be due to the way they neurally activate muscle groups