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Motor control learning at the lumbar spine using sensor-based postural feedback: preliminary results of a randomized controlled trial
No full textIntroduction
Extrinsic feedback can be provided in different ways during motor control exercises for patients with low back pain (LBP). However, little is known about the most effective form of feedback.
Aims
(1) To evaluate whether sensor-based postural feedback is more effective than conventional feedback to learn a motor control task for the lumbar spine. (2) To assess whether there is a carry-over effect from an analytical to a functional task.
Materials and methods
Thirty healthy adults who experienced no LBP and performed no lumbar stabilization exercises in the past year were recruited. At baseline assessment, participants were asked to perform a forward bending movement in the hip joints (waiter’s bow, analytical task) and to lift a box (functional task), while keeping the physiological lordosis in the lumbar spine. Each task was repeated five times, and both conditions were standardized to the subject’s height. Lumbopelvic kinematics (deviation from the starting position in the lumbar spine and hip) were measured with inertial sensors (Valedo®Motion, version 1.0) placed at L1, S1 and the femur. After the baseline evaluation, participants were randomized into three groups: the sensor-group (SG) received sensor-based postural feedback on a computer screen, the mirror-group (MG) received mirror-based feedback and the control-group (CG) received no feedback. After randomization, subjects practiced the waiter’s bow (3 x 6 repetitions), during which they received their assigned form of feedback. Lumbopelvic kinematics of both tasks were re-assessed immediately after the learning phase.
Results
Regarding the waiter’s bow, the mean maximal deviation in the lumbar spine decreased in the SG (23.4° to 12.8°, p< 0.01), while there was no significant difference in the MG (18.4° to 20.4°) and the CG (20.5° to 19.7°). Post-hoc analysis showed that there was a between group difference in favor of the SG, which improved more than the MG and CG (p< 0.05). No significant within and between group differences were present for the lifting task, although there was a trend towards a within group improvement in the SG (p= 0.09). Results for the hip angles are currently being analyzed.
Conclusions
Sensor-based postural feedback appears to be more effective than conventional feedback and no feedback for improving task-specific motor control training. There was no carry-over effect to the functional task, suggesting that motor control training should be task-specific or that the duration of the learning period was not sufficient. These results should be confirmed in a low back pain population
Technology-supported exercise therapy for patients with chronic non-specific low back pain: a feasibility study
No full textIntroduction Various technological systems supporting exercise therapy for low back pain (LBP) have been developed in recent years. One of the problems with the current technology-supported exercise therapy programs for LBP is that they mostly adopt an analytical approach.Purpose/Aim(1) To develop a functional exercise therapy program supported by sensor-based postural feedback, and (2) to evaluate this program in a pilot study.Materials and methodsTen patients with chronic non-specific low back pain and an underlying motor control impairment were recruited. The subjects participated in a rehabilitation program consisting out of 36 sessions (18 weeks). Subjects mainly performed a partially supervised exercise program that included 30 minutes of general conditioning and 90 minutes of functional motor control exercises. The motor control exercises were tailored to the patient’s specific needs and used concepts of segmentation and simplification. During these exercises, postural feedback from motion sensors (ValedoMotion, version 1.2) placed at the L1 and S1 level was provided to the patients. In addition, serious games that had to be controlled by pelvic tilts were used to improve thoracolumbar dissociation. The technological support was also available for home exercises. Primary outcomes were pain (numeric pain rating scale), disability (Roland Morris questionnaire and patient specific functioning scale), self-efficacy (pain self-efficacy questionnaire), kinesiophobia (Tampa scale for kinesiophobia) and treatment satisfaction. Secondary outcomes were quality of life (short form-36), motivation (intrinsic motivation inventory) and credibility and expectancy of the treatment (credibility and expectancy questionnaire).ResultsExcept for treatment satisfaction, there was a significant improvement on all of the primary outcomes. The differences in median scores between baseline and post-intervention were clinically relevant for pain and disability: pain improved 3 points on the numeric pain rating scale (p< 0.05), disability was reduced by 5.5 points on the Roland Morris questionnaire (p< 0.01) and by 3 points on the patient specific functioning scale (p< 0.01). For the secondary outcomes, there was a significant improvement on two subscales of the IMI (p< 0.01) and on the physical component of the short form-36 (p< 0.001). No significant differences were found for the CEQ.ConclusionsIt is feasible to use sensor-based postural feedback in combination with functional exercises, and this approach leads to clinically important improvements in pain and disability. An adequately powered randomized controlled trial should be conducted to confirm the results from this pilot study. To assess the additional value of the postural feedback, this program should be compared to an exercise program without technological support
Serious Gaming to Support Exercise Therapy for Patients with Chronic Nonspecific Low Back Pain: A Feasibility Study
No full textObjective: To investigate the feasibility of a functional exercise program supported by serious gaming for patients with chronic nonspecific low back pain (LBP). Methods: Ten patients with chronic nonspecific LBP and an underlying motor control impairment were recruited. Subjects performed a partially supervised exercise program (36 sessions, 18 weeks) that included 30 minutes of general conditioning and 90 minutes of individually tailored functional motor control exercises (MCEs). Serious games (SGs) were used to (1) improve thoracolumbar dissociation and (2) to provide postural feedback during functional MCEs. The SGs were also available at home. Results: Treatment satisfaction and the scores on the credibility/expectancy questionnaire were good and did not change throughout the intervention. Patients remained motivated throughout the rehabilitation program and no serious adverse events were reported. Overall, participants indicated that the SGs helped them to perform the home exercises more correctly, and as a consequence, they felt more confident doing them. However, the time needed to set up the games was a barrier for home use and participants would have found it useful to receive postural feedback during daily life activities. Conclusions: It is feasible to support a functional exercise program with SGs for patients with chronic nonspecific LBP, both in a supervised and a home environment. Time-efficiency and the integration of SGs in daily life activities are challenges that need to be addressed in the future
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Invloed van een multidisciplinair revalidatieprogramma op de fysiek en psychosociale conditie van patiënten met een oncologische pathologie
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