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Sport- und Bewegungstherapie für den weiblichen Beckenboden. Alltagsrelevanz, Analyse und Therapie unter besonderer Berücksichtigung der neuromuskulären Ansteuerung
Get PDFHintergrund: Die Beckenbodenmuskulatur stellt eine wichtige Muskelgruppe zum Erhalt der Kontinenz sowie zur Stabilisierung des Rumpfes dar. Sie ist jedoch hinsichtlich ihrer neuromuskulären Aktivität in Physiologie, Analyse und Therapie bislang noch wenig erforscht. Es fehlen insbesondere gesicherte Erkenntnisse zur intermuskulär-koordinativen Einbindung in alltägliche Haltungen und Bewegungen sowie in unterschiedliche Übungskontexte. Darüber hinaus mangelt es an gesicherten Erkenntnissen in vergleichenden Analysekonzeptionen zwischen gesunden und belastungsinkontinenten Probandinnen. Ferner existieren keine expliziten Parameter als Grundlage eines therapeutischen Trainings.
Ziel: Das Ziel der vorliegenden Studien ist die Evaluation der neuromuskulären Ansteuerung der Beckenbodenmuskulatur bei physiologischen Haltungen und Bewegungen, ihre vergleichende Beurteilung zu belastungsinkontinten Frauen sowie die Evaluation eines Biofeedback-gestützten Therapiekonzeptes, welches explizit trainingssteuernde Parameter berücksichtigt.
Methode: Bei den 3 Studien handelt es sich um zwei Querschnittstudien (Studie 1,2) sowie eine Längsschnittstudie (Studie 3). Insgesamt standen 102 Probandinnen zu Verfügung. Bei der Gruppe der Patientinnen (N=67) handelte es sich um belastungsinkontinente Frauen (N=67) im Alter zwischen 28 und 88 Jahren. Die gesunde Probandengruppe (N-37) befand sich im Alter zwischen 23 und 46 Jahren. Mittels Fragebogenevaluation wurden die anamnestischen und symptombezogenen Daten der Probandinnen erfasst. Die Evaluation der neuromuskulären Ansteuerung erfolgte mittels Oberflächen-Elektromyographie. Folgende Muskeln werden abgeleitet: Mm. pelvic floor, M. obliquus internus, M. rectus abdominis, M. glutaeus maximus (Studie 2, 3). Für die Studie 1 wurden zusätzlich der M. obliquus externus, der M. multifiduus, der M. erector spinae und die Mm. adductores abgeleitet. Die Ableitung der Beckenbodenmuskulatur erfolgte mittels intravaginaler Sonde. In der Studie 3 wurden die prozessgestützten Parameter für ein Muskeltraining definiert und über Biofeedback gesteuert. Zur qualitativen und quantitativen Datenanalyse wurde das Roh-EMG-Signal den gängigen signalverarbeitenden Prozessen Gleichrichtung, Glättung und Normalisierung unterzogen. In den hier vorliegenden Studien wurden die EMG-Signale mit einem gleitenden Mittelwert von 100 Datenpunkten geglättet (Root Mean Sqare 100 ms Zeitkonstante). Die Daten aller Probandinnen wurden auf uV-Niveau ausgewertet, die Ergebnisse der gesunden Probandinnen zusätzlich MVC-normalsiert. Die statistische Auswertung erfolgte für die EMG-Daten durch eine multifaktoirielle Varianzanalyse. Die Fragebögen wurden mittels dem Mann-Whitney-U-Test (Studie 2) und dem Wilkoxon Test (Studie 3) statistisch ausgewertet.
Ergebnisse: Studie 1: In nahezu allen untersuchten Haltungen und Bewegungen des täglichen Lebens sowie in Übungssituationen ist die Beckenbodenmuskulatur die prozentual aktivste Muskelgruppe. Bei den untersuchten Übungen wurden die höchsten neuromuskulären Aktivitäten bei apparativ-gestützter Durchführung erreicht. Eine initiale bewusste Anspannung führt zu einem signifikanten Anstieg der neuromuskulären Aktivität. Insgesamt wurde eine intermuskuläre Koordination mit der gesamten posturalen Muskulatur belegt. Studie 2: Die Gruppe der belastungsinkontinenten Probandinnen unterschied sich in allen Items signifikant zur Gruppe der gesunden Probandinnen. Die Ergebnisse der EMG-Analyse belegten signifikante Unterschiede für alle untersuchten Testsequenzen im Vergleich der Gruppen. Durch eine isolierte Anspannung konnte keine maximale Aktivität der Beckenbodenmuskulatur erreicht werden. In stehender Position konnte die posturale Sicherung beurteilt werden. Studie 3: Durch Biofeeback-gestützte Therapiekonzept konnten signifikante Verbesserungen der neuromuskulären Ansteuerung sowie der Inkontinenz-Symptomatik erreicht werden. Sportliche Aktivität und Beteiligung am gesellschaftlichen Leben stiegen signifikant an.
Schlussfolgferung: Die Beckenbodenmuskulatur ist in sämtliche Haltungen und Bewegungen intermuskulär eingebunden und stellt somit einen enormen Beitrag zur Stabilisierung des Rumpfes dar. Im Falle einer Belastungsinkontinenz ist sie dysfunktional beeinträchtigt. Biofeedback bietet sich zur Trainingssteuerung in therapeutischen Konzepten an.
Key words Elektromyographie, Belastungsinkontinenz, neuromuskuläre Ansteuerung, Biofeedback, Training, Haltungskontrolle, Krafttraining.
Sport and exercise therapy for the pelvic floor muscles. Relevance to daily life, analysis and therapy with regard to neuromuscular activation.
Background: The pelvic floor muscles represent an important group of muscles in respect to the preservation of continence as well as trunk stabilisation. There are no randomised controlled reports or trials concerning the neuromuscular activation in physiology and analysis or even in regard to the effectiveness of any treatment of stress urinary incontinence. The assessment of intermuscular-coordiantion integrated into daily life regarding posture and various physical activities as well as different training aspects have largely been neglected. Furthermore, consolidated findings comparing analysis concepts between healthy and stress urinary incontinence subjects have not been made. Moreover explicit parameters as a basis for therapeutic intervention fail to exist.
Purpose The objective of the trials lies in the evaluation of the neuromuscular activation of the pelvic floor muscles. The first trial determines the neuromuscular activation whilst maintaining the physiological posture during physical activities and the activities of daily living as well as under exercise conditions. The second trial, using an EMG-based analysis-concept is evaluated by comparing healthy and stress urinary incontinent subjects. In a third trial an EMG-based Biofeedback therapy concept that focusses the explicit muscle training parameters is evaluated.
Method The three trials consist of two cross-sectional trials (trial 1 and 2) as well as one longitudinal trial (trial 3). The trials involved 102 female subjects in total, who were subgrouped by diagnosis. One group consisting of healthy female subjects (N-37) were between the ages of 23 and 46 years. The other group consisting of stress urinary incontinent subjects (N=67) were between the ages of 28 to 88 years. The anamnesis and symptom data of the subjects was assessed using two questionnaires. Neuromuscular activation was evaluated by means of sEMG. The following muscles were derived: Mm. pelvic floor, M. obliquus internus, M. rectus abdominis, M. glutaeus maximus (trial 3). In addition the M. obliquus externus, the M. multifiduus, the M. erector spinae and the Mm. adductores were derived in the first trial (trial 1). In the third trial the process based parameters for the specific strength training were defined and controlled via Biofeedback. The EMG-signals were raw-EMG without any filter detection and the data of all subjects were interpreted on uV-level. The results of the healthy group were additionally MVC-normalised. The obtained data was analysed using the RMS 100 filter. The EMG data was statistically analysed by means of the multifactor variance analysis and the questionnaires were evaluated using the Mann-Whitney-U-test and the Wilcoxon Test.
Results Trial 1: In almost all evaluated movements concerning posture, activities of daily life as well as movements conducted during exercise, the Mm. pelvic floor is significantly the most active muscle group. The highest neuromuscular activation was achieved during the apparative-based strength training. The intentional initial activation leads to a significant increase of the neuromuscular activation. All postural muscles participating in the intermuscular coordination were documented in the trials. Trial 2: The results show that stress urinary incontinence patients differ significantly in all items in comparison to the healthy group. The results of the EMG-analysis show a significant difference for all test sequences. The maximum activity during an isolated activation of the pelvic floor muscle can not be achieved. The basis positions standing and supine differ significantly in the active test sequences. Trial 3: Significant changes concerning neuromuscular activation and incontinence symptoms were achieved through the Biofeedback-based therapy concept. Physical activity and the participation in daily life increased significantly aswell.
Conclusion: The pelvic floor muscles are integrated in all postural movements and physical activities and therefore make an enormous contribution to the trunk stabilisation. In the case of stress urinary incontinence the muscles are dysfunctionally affected. Biofeedback helps to control and optimise strength training in various therapeutical concepts.
Key words Electromyography, stress urinary incontinence, neuromuscular activation, Biofeedback, postural activity, strength training
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Get PDF“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
Get PDFWe 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
Get PDFWe 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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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