Active Movement Research Articles

Фізична активність підлітків в умовах соціального обмеження

A decrease in active movement is the cause of many diseases of modern man. The majority of schoolchildren in Ukraine (70.6% of boys and 83.0% of girls, 2016) did not follow recommendations for physical activity (PA). During the quarantine due to the COVID-19 pandemic, children’s PA was limited in many countries of the world. Increasing motor activity is one of the powerful means of preventing a number of cardiovascular diseases and metabolic disorders. Purpose - to determine the levels of PA of adolescents in the conditions of quarantine restrictions in connection with the COVID-19 pandemic; to establish the types of activities that ensure sufficient and low motor activity; to indicate ways of increasing it in adolescence. Materials and methods. The analysis of 138 questionnaires of teenagers aged 10-18 from spring 2020 to February 2022 was carried out: 68 girls and 70 boys. PA of adolescents was assessed using the International Adapted Physical Activity Questionnaire. All types of РA during the week (sports sections, active games, morning exercise, hiking, physical education classes) and the time spent on each type were taken into account. A total score of up to 7 points corresponded to low РA, from 7 to 8.9 to moderate, more than 9 to high РA. Results. 50.1% of teenagers had low FA, 22.4% middle, and 27.5% high. In the group of teenagers with low РA, only a third had motor games in the fresh air and morning exercises, 62% of them attended physical education classes and 18% - a sports section. Children with average РA in 35% of cases attended the section, 84% - physical education classes, and every second one did morning exercises and had active games. High РA consisted of a combination of sports (82%) and physical education lessons (87%), active games (66%) and morning exercises (68%). Almost all teenagers, regardless of the level of РA, had walks, but for every third person with low РA, their duration did not exceed 30 minutes. With average and high РA, the duration of walks in most people was more than 40 minutes. Conclusions. A more important task for educators, parents, doctors and the state as a whole is to increase the motivation of teenagers to physical culture and expand health and sports areas, their adaptation in periods of social restrictions. To achieve optimal РА, both the variety of types of activity and their duration are important. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Spatial-temporal pattern evolution and geological influence factors analysis of ecological vulnerability in Western Sichuan mountain region

Compared to plains, hills and basins, mountainous areas with complex topography are more prone to ecological and environment vulnerability to climate change, human interference and geological disasters. This type of region is usually located in abrupt transitional zones, which marked by active neotectonic movements, high-incidence mountain disasters, abundant available resources, slower economic development, diverse eco-environment and insufficient cultivated land resources. Therefore, it is of great significance to determ the vulnerability status and spatial–temporal change process of the eco-environment in mountainous area with complex topography. In this study, data derived from vegetation, topography, soil, meteorological and human social factors were used to develop an evaluation index system that can reflect the characteristics of the eco-environment in the mountain area. Employing the Genetic Projection Tracing Model (RAGA-PPM), we developed a framework for assessing the vulnerability of mountainous areas with complex terrains and applied it to the western Sichuan mountain region, China. In addition, the relationship between the geological factors and the vulnerability of eco-environment was quantitatively analyzed by using the geographic detector. The results indicate that (1) The overall vulnerability was medium and the spatial distribution was higher in the central and eastern parts and lower in the surrounding areas. The area with high vulnerability accounted for 27.9%. (2) The overall degree of vulnerability increased from2010 to 2020, the eco-environment experienced a rapid deterioration from 2010 to 2015, followed by a slower improvement from 2015 to 2020. (3) Correlations were minimal between vulnerability results and fault density and earthquake dynamic peak acceleration, the influence of other geological factors ranged from 10% to 25.8%, indicating a nonlinear correlation. (4) This study reveals that the ecological vulnerability of mountain areas was the effect of multiple human and natural factors, and there was a certain correlation between geological environment and vulnerability distribution. These findings can assist decision-makers in providing a scientific basis for managing and developing the ecological environment in mountainous regions.

Developing a serious game for gaze stability rehabilitation in children with vestibular hypofunction

BackgroundChildren with vestibular hypofunction (VH) may have gaze instability, balance disorders, and delayed postural-motor development. Gaze stabilization exercises (GSE) are designed to improve dynamic visual acuity (DVA). We aimed to assess the acceptability of a serious game prototype called Kid Gaze Rehab (KGR) designed to implement GSE training in children with VH, combined with traditional vestibular rehabilitation. Effects on DVA and motor performance were also analyzed.MethodsTwelve children (6 to 9 years old) were included. Sessions were held at the hospital twice a week, for 5 weeks. An adapted French version of The Child Simulator Sickness Questionnaire (SSQ) and the Face Scale Pain-Revised (FPS-R) were used to assess pain in the cervical region and undesirable side effects after each session. Vestibular and motor function parameters (active and passive DVA and Movement Assessment Battery for Children–Second Edition, MABC-2) were assessed before and after the training.ResultsAll children included completed the 10 sessions. The FPS-R visual analog scale and SSQ showed good cervical tolerance and no oculomotor or vegetative adverse effects nor spatial disorientation. After training, active DVA scores were significantly improved for the right, left, and up directions (p < 0.05). Passive DVA scores were significantly improved for the left and down directions (p < 0.01 and p < 0.05, respectively). MABC-2 scores were improved in the balance and ball skill sections (p < 0.05).ConclusionAn innovative pediatric training method, the use of a dedicated serious game for gaze stabilization was well-tolerated as a complement to conventional vestibular rehabilitation in children with VH. Moreover, both DVA and motor performance were found to improve in the study sample. Although replication studies are still needed, serious game-based training in children with VH could represent a promising rehabilitation approach for years to come.Trial registrationThe study was conducted in accordance with the Declaration of Helsinki and approved by an Institutional Review Board (local ethics committee, CPP Sud-Est IV, ID 2013–799). The study protocol was registered on ClinicalTrials.gov (NCT04353115).

Fault logic and data-driven model for operation reliability analysis of the flap deflection angle.

To effectively perform the reliability analysis of the flap deflection angle, the reliability analysis framework is developed by introducing fault logic and a data-driven model. Herein, the fault logic analysis is used to study the fault mechanism and filter out the characteristic fault parameters that can be used to collect input data for data-driven modelling; the data-driven modelling is employed to establish a reliability analysis model with a small amount of input data. Under this proposed framework, the improved dung beetle optimization algorithm for back propagation (IDBO-BP) method is developed to perform the reliability modelling of the flap deflection angle. To validate the effectiveness of the proposed framework, we study the fault logic of flap symmetry and establish a surrogate model of flap deflection based on the fault parameters and the IDBO-BP algorithm. According to the predicted results of the flap deflection angle, the reliability model based on the fault mechanism can reflect the actual flap motion. At the same time, the proposed IDBO-BP algorithm has excellent modelling and simulation property by comparing with other optimization algorithms. Thus, the efforts of this study provide a new solution to the problem of reliable analysis with uncertain fault parameters. This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 1)'.

Correlation between histopathological nerve assessment and clinical recovery in brachial plexus birth injuries.

In the management of brachial plexus birth palsies, the quality of the roots eligible for reconstruction is thought to be a key issue. The aim of the present study was to evaluate the correlations between pathological root examination and motor recovery after brachial plexus reconstructions. Quantitative histopathological analysis of intraneural fibrosis was conducted on 72 nerve transections (40 roots, 18 trunks and 14 suprascapular nerves) in 20 patients. Clinical recovery of targeted muscles after surgery was assessed by standardized functional scores. After a mean follow-up of 32 months, patients with a lower fibrosis rate for the suprascapular nerve had greater global Mallet scores (r = -0.57; p = 0.042) as well as a greater active shoulder flexion (r = -0.66; p = 0.015). Correlations were also found between C6 root and upper trunk fibrosis rate and some of the subsections of the Mallet score, active movement scale for the biceps and active elbow flexion. These results seem to confirm the relevance of intraoperative pathological evaluation of the roots and nerves after neuroma resection to optimally define the reconstruction strategy.Level of evidence: IV.

Optimization of fracture reduction robot controller based on improved sparrow algorithm

The accuracy of a fracture reduction robot (FRR) is critical for ensuring the safety of surgery. Improving the repositioning accuracy of a FRR, reducing the error, and realizing a safer and more stable folding motion is critical. To achieve this, a sparrow search algorithm (SSA) based on the Levy flight operator was proposed in this study for self-tuning the robot controller parameters. An inverse kinematic analysis of the FRR was also performed. The robot dynamics model was established using Simulink, and the inverse dynamics controller for the fracture reduction mechanism was designed using the computed torque control method. Both simulation and physical experiments were also performed. The actual motion trajectory of the actuator drive rod and its error with a desired trajectory was obtained through simulation. An optimized Levy-sparrow search algorithm (Levy-SSA) crack reduction robot controller demonstrated an overall reduction of two orders of magnitude in the reduction error, with an average error reduction of 98.74% compared with the traditional unoptimized controller. The Levy-SSA increased the convergence of the crack reduction robot control system to the optimal solution, improved the accuracy of the motion trajectory, and exhibited important implications for robot controller optimization.

Investigation of uncertainty in internal target volume definition for lung stereotactic body radiotherapy

This study evaluated the validity of internal target volumes (ITVs) defined by three- (3DCT) and four-dimensional computed tomography (4DCT), and subsequently compared them with actual movements during treatment. Five patients with upper lobe lung tumors were treated with stereotactic body radiotherapy (SBRT) at 48 Gy in four fractions. Planning 3DCT images were acquired with peak-exhale and peak-inhale breath-holds, and 4DCT images were acquired in the cine mode under free breathing. Cine images were acquired using an electronic portal imaging device during irradiation. Tumor coverage was evaluated based on the manner in which the peak-to-peak breathing amplitude on the planning CT covered the range of tumor motion (± 3 SD) during irradiation in the left–right, anteroposterior, and cranio-caudal (CC) directions. The mean tumor coverage of the 4DCT-based ITV was better than that of the 3DCT-based ITV in the CC direction. The internal margin should be considered when setting the irradiation field for 4DCT. The proposed 4DCT-based ITV can be used as an efficient approach in free-breathing SBRT for upper-lobe tumors of the lung because its coverage is superior to that of 3DCT.

Development of abnormal facial temperature detection technology using thermal imaging to prevent the spread of infectious diseases

Substantial research has been conducted on image-based augmentation, segmentation, detection, and classification of COVID-19. Thermal image classification methods have been used to identify people with high fever. However, these methods cannot always identify infected patients because aberrant images cannot be detected using face temperatures. For example, if the individual in the thermal image cleansed his/her face a few minutes earlier or was perspiring, the method cannot reliably determine their facial temperature. Moreover, the active movements of the human body can produce temperature variations in the face. Thus, achieving high accuracy remains challenging in thermal facial image identification. Therefore, in this study, a novel research has been conducted to solve the problems. Based on preliminary experimental results, a deep-learning-based classification system was proposed for detecting faces with abnormal facial temperatures in thermal pictures. Two different experiments including abnormal face images detection and classification were conducted. To conduct these experiments, a self-collected thermal face-image dataset including abnormal (faces after exercise, sweaty and wet faces) and normal images was used. In the detection method, a binary image classification was conducted to classify the abnormal and normal images. Moreover, in the classification method, an input image is classified into four classes, such as normal faces (class 1) and three abnormal faces, namely, after physical activity (class 2), sweaty face (class 3), and wet face (class 4). Testing on the dataset collected in this study revealed that the proposed detection and classification methods achieved F1-score of 95.71 and 96.17, respectively. These performances are superior to those of the state-of-the-art methods.

Functional Anatomy of the Thoracic Limb of the Komodo Dragon (Varanus komodoensis).

Since the Komodo dragon has been included on The International Union for Conservation of Nature (IUCN) Red List of Threatened Species, it is crucial to know in detail its biology as there is a limited availability of research material on these animals-mainly those who died in zoos or whose remains were found in the wild. Anatomy is essential for understanding physiology, identification of diseases, adaptations in the environment, and behavior. In this dissection study, the relationship of individual anatomical structures was analyzed, the anatomy of the active and passive movement system of the thoracic limb was described, photographs were taken, and a radiographic examination was conducted. This species has its own differences, even within closely related lizard species. Varanus komodoensis possesses triceps muscles with three heads, and the wrist is extended with additional bones for greater flexibility of the hand. The muscles of the forelimb are analogous to the hind limb; however, they differ in the mass of individual muscles, especially those predisposed to perform the most important antigravity and locomotive functions.

The Deformation Characteristics of the Zhuka Fault in Lancang River and Its Influence on the Geostress Field

The construction of infrastructure projects such as the Sichuan–Tibet Railway and western cascade hydropower stations has led to the increasing development of ultra-long and deeply buried tunnels in an environment characterized by highly active neotectonic movement, which affects the sustainable development of ecological civilization in Tibet. However, the effects of faults resulting from tectonic activity on the distribution of geostress fields have not been systematically studied. This research focuses on the development characteristics and basic type of the Zhuka fault near the RM hydropower station, aiming to analyze the phenomenon of geostress concentration in the study area. Field investigations have revealed significant high-geostress damage on the downstream slope of the lower dam site, situated on the hanging wall of the Zhuka fault. The results indicate a correlation between these high-geostress phenomena and the Zhuka fault, suggesting the concentration of geostress within a certain range on the hanging wall and outside of the fault zone. Stress concentration primarily depends on the characteristics of fault thrusting and fault morphology. The left-lateral strike-slip and thrusting process of the Zhuka fault, combined with NNW-directed tectonic compression stress and sudden changes in fault strike, contribute to geostress concentration within a specific range of the fault hanging wall. The observed high-geostress damage to the hard rock on the valley slope results from the combined effect of construction stress concentration and fourth-order valley incision stress concentration, which influences site selection for the RM hydropower station, thereby highlighting the role of geostress concentration outside the fault zone in engineering practice. This study provides valuable insights into geostress concentration and its implications for sustainable development in the Sichuan–Tibet region.

Motor imagery has a priming effect on motor execution in people with multiple sclerosis.

Priming is a learning process that refers to behavioral changes caused by previous exposure to a similar stimulus. Motor imagery (MI), which involves the mental rehearsal of action representations in working memory without engaging in actual execution, could be a strategy for priming the motor system. This study investigates whether MI primes action execution in Multiple Sclerosis (MS). Here, 17 people with MS (PwMS) and 19 healthy subjects (HS), all right-handed and good imaginers, performed as accurately and quickly as possible, with a pencil, actual or mental pointing movements between targets of small (1.0 × 1.0 cm) or large (1.5 × 1.5 cm) size. In actual trials, they completed five pointing cycles between the left and right targets, whereas in mental trials, the first 4 cycles were imagined while the fifth was actually executed. The fifth cycle was introduced to assess the MI priming effect on actual execution. All conditions, presented randomly, were performed with both dominant (i.e., right) and non-dominant arms. Analysis of the duration of the first 4 cycles in both actual and mental trials confirmed previous findings, showing isochrony in HS with both arms and significantly faster mental than actual movements (anisochrony) in PwMS (p < 0.01) [time (s); HS right: actual: 4.23 ± 0.15, mental: 4.36 ± 0.16; left: actual: 4.32 ± 0.15, mental: 4.43 ± 0.18; PwMS right: actual: 5.85 ± 0.16, mental: 5.99 ± 0.21; left: actual: 6.68 ± 0.20, mental: 5.94 ± 0.23]; anisochrony in PwMS was present when the task was performed with the non-dominant arm. Of note, temporal analysis of the fifth actual cycle showed no differences between actual and mental trials for HS with both arms, whereas in PwMS the fifth actual cycle was significantly faster after the four actual cycles for the non-dominant arm (p < 0.05) [time (s); HS right: actual: 1.03 ± 0.04, mental: 1.03 ± 0.03; left: actual: 1.08 ± 0.04, mental: 1.05 ± 0.03; PwMS right: actual: 1.48 ± 0.04, mental: 1.48 ± 0.06; left: actual: 1.66 ± 0.05, mental: 1.48 ± 0.06]. These results seem to suggest that a few mental repetitions of an action might be sufficient to exert a priming effect on the actual execution of the same action in PwMS. This would indicate further investigation of the potential use of MI as a new motor-cognitive tool for MS neurorehabilitation.

Comparison of visitor experiences of virtual reality exhibitions by spatial environment

The growing interest in the metaverse has led to a corresponding increase in attention towards virtual reality (VR) exhibitions. Furthermore, with the potential and possibility of a virtual environment without physical and economic constraints, expectations for user experiences based on diverse exhibition environments are increasing. Accordingly, this study investigated the characteristics of visitor experience in relation to the spatial environment of VR exhibitions, particularly focusing on the representational fidelity of the real-physical world. We experimented with comparing the user experience in reality-based (realistically representing the physical world, high representational fidelity level) and virtuality-based (surreal, low representational fidelity level) VR exhibition settings to explore design implementation. User experience data were collected through surveys, behavioral observation by video recording, and interviews. In terms of surveys, there was no significant difference in presence and enjoyment by environment, but the reality-based environment was scored significantly higher for communication. The behavioral analysis found that more active movements were captured in the virtuality-based environment. Qualitative analysis of the interview found differences in perception, emotions, and behavior by spatial environment, such that the newness and openness of the virtuality-based environment induced active movement of participants, and the familiarity of the reality-based environment provided comfortable feelings and supported participants’ concentration on exhibition contents. The results of the study suggest how the spatial environment of VR exhibitions can contribute to user experiences.

Muscle stimulation for peripheral venous oxygen saturation estimation using photoplethysmography: a proof-of-concept

Abstract The body’s ability to balance oxygen supply and demand can be compromised in conditions such as shock, sepsis, and heart failure. Thus, measuring venous oxygen saturation (SvO2) simultaneously with the well-established peripheral arterial oxygen saturation can help in the clinical management of these conditions. Some authors have suggested a non-invasive SvO2 estimation method that acquires venous blood volume variations generated through the calf muscle pump using photoplethysmography (PPG): the Venous Muscle Pump Test (VMPT). However, the technique presents significant variability in the rhythm and speed of the foot dorsal flexions needed for the VMPT and cannot be performed on unconscious subjects and those with reduced mobility. This study proposes using functional electrical stimulation (FES) to stimulate the calf muscle and generate rhythmic and reproducible muscle contractions. A human proof-of-concept study was conducted with three healthy young male participants. The PPG signals achieved through the VMPT with conventionally active and FES-induced movements were compared. We found that FES-induced movement produced reproducible venous blood volume variations comparable to the ones induced by the active movement. However, it also leads to lower venous refilling time and lower muscle power. Although further individualized tuning of the stimulation parameters is needed to achieve more conclusive results, FES-induced movement proves to be a promising alternative to the conventional VMPT technique to measure venous oxygen saturation and assess venous insufficiency in specific clinical situations.

Decoding hand kinetics and kinematics using somatosensory cortex activity in active and passive movement

Area 2 of the primary somatosensory cortex (S1), encodes proprioceptive information of limbs. Several studies investigated the encoding of movement parameters in this area. However, the single-trial decoding of these parameters, which can provide additional knowledge about the amount of information available in sub-regions of this area about instantaneous limb movement, has not been well investigated. We decoded kinematic and kinetic parameters of active and passive hand movement during center-out task using conventional and state-based decoders. Our results show that this area can be used to accurately decode position, velocity, force, moment, and joint angles of hand. Kinematics had higher accuracies compared to kinetics and active trials were decoded more accurately than passive trials. Although the state-based decoder outperformed the conventional decoder in the active task, it was the opposite in the passive task. These results can be used in intracortical micro-stimulation procedures to provide proprioceptive feedback to BCI subjects.

Classification algorithm for EEG-based motor imagery using hybrid neural network with spatio-temporal convolution and multi-head attention mechanism.

Motor imagery (MI) is a brain-computer interface (BCI) technique in which specific brain regions are activated when people imagine their limbs (or muscles) moving, even without actual movement. The technology converts electroencephalogram (EEG) signals generated by the brain into computer-readable commands by measuring neural activity. Classification of motor imagery is one of the tasks in BCI. Researchers have done a lot of work on motor imagery classification, and the existing literature has relatively mature decoding methods for two-class motor tasks. However, as the categories of EEG-based motor imagery tasks increase, further exploration is needed for decoding research on four-class motor imagery tasks. In this study, we designed a hybrid neural network that combines spatiotemporal convolution and attention mechanisms. Specifically, the data is first processed by spatiotemporal convolution to extract features and then processed by a Multi-branch Convolution block. Finally, the processed data is input into the encoder layer of the Transformer for a self-attention calculation to obtain the classification results. Our approach was tested on the well-known MI datasets BCI Competition IV 2a and 2b, and the results show that the 2a dataset has a global average classification accuracy of 83.3% and a kappa value of 0.78. Experimental results show that the proposed method outperforms most of the existing methods.

How Free Swimming Fosters the Locomotion of a Purely Oscillating Fish-like Body.

The recoil motions in free swimming, given by lateral and angular rigid motions due to the interaction with the surrounding water, are of great importance for a correct evaluation of both the forward locomotion speed and efficiency of a fish-like body. Their contribution is essential for calculating the actual movements of the body rear end whose prominent influence on the generation of the proper body deformation was established a long time ago. In particular, the recoil motions are found here to promote a dramatic improvement of the performance when damaged fishes, namely for a partial functionality of the tail or even for its complete loss, are considered. In fact, the body deformation, which turns out to become oscillating and symmetric in the extreme case, is shown to recover in the water frame a kind of undulation leading to a certain locomotion speed though at the expense of a large energy consumption. There has been a deep interest in the subject since the infancy of swimming studies, and a revival has recently arisen for biomimetic applications to robotic fish-like bodies. We intend here to apply a theoretical impulse model to the oscillating fish in free swimming as a suitable test case to strengthen our belief in the beneficial effects of the recoil motions. At the same time, we intend to exploit the linearity of the model to detect from the numerical simulations the intrinsic physical reasons related to added mass and vorticity release behind the experimental observations.

Repeated deep-inspiration breath-hold CT scans at planning underestimate the actual motion between breath-holds at treatment for lung cancer and lymphoma patients

Purpose/objectiveDeep-inspiration breath-hold (DIBH) during radiotherapy may reduce dose to the lungs and heart compared to treatment in free breathing. However, intra-fractional target shifts between several breath-holds may decrease target coverage. We compared target shifts between four DIBHs at the planning-CT session with those measured on CBCT-scans obtained pre- and post-DIBH treatments. Material/methodsTwenty-nine lung cancer and nine lymphoma patients were treated in DIBH. An external gating block was used as surrogate for the DIBH-level with a window of 2 mm. Four DIBH CT-scans were acquired: one for planning (CTDIBH3) and three additional (CTDIBH1,2,4) to assess the intra-DIBH target shifts at scanning by registration to CTDIBH3. During treatment, pre-treatment (CBCTpre) and post-treatment (CBCTpost) scans were acquired. For each pair of CBCTpre/post, the target intra-DIBH shift was determined. For lung cancer, tumour (GTV-Tlung) and lymph nodes (GTV-Nlung) were analysed separately. Group mean (GM), systematic and random errors, and GM for the absolute maximum shifts (GMmax) were calculated for the shifts between CTDIBH1,2,3,4 and between CBCTpre/post. ResultsFor GTV-Tlung, GMmax was larger at CBCT than CT in all directions. GMmax in cranio-caudal direction was 3.3 mm (CT)and 6.1 mm (CBCT). The standard deviations of the shifts in the left–right and cranio-caudal directions were larger at CBCT than CT. For GTV-Nlung and CTVlymphoma, no difference was found in GMmax or SD. ConclusionIntra-DIBH shifts at planning-CT session are generally smaller than intra-DIBH shifts observed at CBCTpre/post and therefore underestimate the intra-fractional DIBH uncertainty during treatment. Lung tumours show larger intra-fractional variations than lymph nodes and lymphoma targets.

Evaluating the feasibility of implementing the Sup-ER protocol for infants with brachial plexus birth injury

BackgroundThe Sup-ER protocol involves a repositioning program for infants with brachial plexus birth injury to position the shoulder in external rotation (ER) to address progressive loss in passive range of motion (PROM). The British Columbia Children’s Hospital (BCCH) eligibility criteria for this protocol are infants aged 4-8 weeks with decreased shoulder ER PROM and/or Active Movement Scale (AMS) shoulder ER and/or supination scores ≤2. The resources needed to implement this protocol in large clinics have not been studied. PurposeThis study aims to evaluate the BCCH criteria that are used to identify appropriate candidates for the Sup-ER protocol. Study DesignA retrospective cohort study was conducted to identify the percentage of infants who would have been recommended the Sup-ER protocol based on their PROM and AMS scores between 4 and 8 weeks of age. MethodsA sensitivity and specificity evaluation was used to describe the BCCH criteria's ability to identify infants in this historical cohort who went on to have incomplete shoulder function (ie, true positive) vs infants who had functional shoulder outcome at 9 months of age (ie, false positive). ResultsAt a mean of 5.8 weeks (95% confidence interval [CI] 5.3, 6.3), 46 of the 87 (53%) infants satisfied the BCCH Sup-ER protocol criteria. Forty-four (51%) were female, half (n = 45) were left side affected, and 88% had upper plexus injury. The BCCH Sup-ER protocol criteria had sensitivity of 100% and specificity of 71% to identify infants with incomplete shoulder function. Removing the AMS supination ≤2 score criterion from the criteria improves the specificity to 84%, while sensitivity remains high (97%). ConclusionsModifying the BCCH criteria to all infants aged 4-8 weeks with AMS shoulder ER ≤2 and/or decreased shoulder ER PROM improves the precision of identifying infants who would benefit from the Sup-ER protocol.

Poster (Health Services, Economics and Policy Change) ID 1977284

Background/Objective Activity-based therapies (ABT) are task specific, repetitive and intensive active movement interventions that may improve function and independence for individuals with spinal cord injury. The cost of implementing ABT is an important consideration for rehabilitation facilities interested in providing this intervention. Thus, a scoping review was conducted to evaluate the economic evidence for ABT for the rehabilitation of upper or lower limb impairment. Design/Methods A search of various scientific literature databases (including EMBASE, MEDLINE and CINAHL) was conducted using search terms developed in collaboration with a Medical Librarian. Studies were included if they were economic analyses of an ABT conducted for individuals with upper or lower limb mobility impairment. Titles and abstracts were initially screened by two of the authors followed by a full-text review of remaining articles. Articles included in the review were evaluated for methodological quality and presented descriptively because of the heterogeneity in study design, populations and outcomes. Results Of the 6,031 unique citations originally identified, 14 articles were included after full-text screening. Two-third of the studies were for stroke and half of the studies originated from the US. Robot-assisted therapies represented half of the studies and about a quarter were locomotor training programs. In the stroke and spinal cord injured population, robot-assisted therapies and body supported treadmill therapy appear to be cost-effective respectively. Conclusions There is some evidence to support the cost-effectiveness of robot-assisted therapies and body supported treadmill therapy. However, the evidence is very limited and additional research is needed.

Case Study: The Application of Extracorporeal Shockwave Therapy (ESWT) and Active Finger Blocking Exercise on Movement and Function of Fingers Disorders Caused by Trigger the 4th Finger Dextra

Background: Trigger finger also referred to as stenosing tenosynovitis. It is a traumatic condition that involves the formation of nodules in the tendons of flexor digitorium muscle due to a combination of repetitive finger movements or local trauma and impaired healing, as a result of which the affected finger is locked in either a flexed or extended position thereby impeding movement. Objective: This case study was aimed to determine the effect of extracorporeal shockwave therapy, and active finger blocking exercise in one women patient, aged 47 years old with diagnosed of trigger the 4th finger dextra. Methods: This case studies have been carried out 6 times for 2 weeks in one women patient, by evaluating the degree of pain by using the Visual Analogue Scale (VAS), Joint Range of Motion (RoM) by using a goniometer and functional activity ability hands with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Results: There was a decrease in the motion pain degree from VAS 7 to VAS 4, and the degree of tenderness pain from VAS 5 to VAS 2. There was an increase active flexion-extension movement of the 4th finger dextra from (S)=25°-0°-50° to (S)=40°-0°-75°, while passive movement from (S)=30°-0 °-60° to (S)=40°-0°-75°. There was a decrease in the value of hand disabilities based on the results of the DASH questionnaire from 24% to 21%. Conclusion: The application of extracorporeal shockwave therapy and active finger blocking exercise can reduce the pain, increase the range of motion and functional abilities patient diagnosed Trigger the 4th Finger condition.