Effect Of Real-time Feedback Research Articles

Effectiveness of Feedback with Mobile Devices for Quality Measure of CPR Training: A Systematic Review

Cardiopulmonary resuscitation (CPR) is a life-saving skill that can significantly increase survival rates in an emergency. Medical professionals, health students, and trained lay people must all perform high-quality CPR. As an outcome, effective CPR training using instruments that support the achievement of high-quality CPR is essential. Objective: This systematic review aimed to evaluate the effectiveness of feedback provided via mobile devices in measuring the quality of CPR training. Method: Design used systematic review with reference to the PRISMA Statement Guidelines 2020. Search results through database of ScienceDirect (778 articles), Wiley Online Library (765 articles), PubMed (55 articles), and ResearchGate (73 articles). The research designs of articles analyzed was randomized controlled trial which published from 2013 to 2023 with the keywords cardiopulmonary resuscitation, CPR training, mobile devices. The sample in this study was taken from five articles that match the inclusion criteria. JBI's critical assessment tool for assessing bias risk in randomly controlled 2023 checklist tests is used to critically evaluate the instruments used for the selected article. Results: The primary results that five publications were based on CPR quality metrics such as chest compression depth and speed, as well as the proportion of acceptable chest compression depth. Conclusions: This review discovered evidence that mobile devices have an effect on the effectiveness of real-time feedback on CPR quality in CPR training. CPR trainees received effective instant guidance from a variety of mobile devices, including smartphones and smart watches equipped with sensors.

Immediate Effects of Real-Time Feedback During Overground Gait Performed Using Inertial Measurement Units on Gait Parameters in Healthy Young Participants: A Cross-Sectional Study.

This cross-sectional study examined the immediate effects of four types of real-time feedback during overground gait performed using inertial measurement units on gait kinematics in healthy young participants. Twelve healthy young participants (mean age: 27.1years) performed 60-s gait trials with each of the following real-time feedback: walking spontaneously (no feedback trial); increasing the ankle plantar-flexion angle during the late stance (ankle trial); increasing the leg extension angle, defined the location of the ankle joint relative to the hip joint in the sagittal plane, during late stance (leg trial); and increasing the knee flexion angle during the swing phase (knee trial). Tilt angles and accelerations of the pelvis and lower limb segments were measured using seven inertial measurement units pre- and postfeedback trials. The differences in gait parameters pre- and postfeedback according to the types of feedback were compared using one-factor repeated-measures analysis of variance, Friedman test, and post hoc test. Real-time feedback in the ankle trial increased gait speed, step length, and ankle plantar-flexion angle compared to the no feedback trial (p ≤ .001). Meanwhile, real-time feedback in the leg trial increased step length and hip extension angle compared to the no feedback trial (p ≤ .001) and showed a tendency to increase gait speed and leg extension angle. Real-time feedback using inertial measurement units increased gait speed immediately with specific changes in gait kinematics in healthy participants. This study might imply the possibility of clinical application for overground gait training, and further studies are needed to clarify the effectiveness for older people.

The effect of Real-Time feedback and incentives on speeding behaviors using Telematics: A randomized controlled trial

Speeding behaviour of drivers is highly correlated to their tangible consequence. Therefore, this study aimed to evaluate the effectiveness of telematics-based feedback and financial incentives in reducing speeding behaviors through a randomized controlled field trial. This randomized controlled trial included four groups of (1) control, (2) information-only, (3) gain-of-reward, and (4) loss-of-reward. While drivers of the control group were unobtrusively monitored using telematics devices, drivers of the information-only group received real-time, weekly, and monthly feedback via text message. In both groups with financial incentives, in addition to receiving feedback, drivers could receive payments at the end of each month based on observed speeding. The primary outcome was the distance traveled at speeds more than 10% (S10 + ) above the posted speed limit as a proportion of the total traveled distance. A total of 397 male taxi drivers consented to participate in the study. After the stratified randomization, the mean age of the participant was 46.0 (95% Confidence Interval: 43.8 to 48.2), 47.0 (44.7 to 49.3), 46.1 (43.7 to 48.5), and 48.8 (46.5 to 51.1) years for the control, the information-only, the gain-of-reward, and the loss-of-reward groups, respectively. The mean S10 + rate per 100 km was 0.9 (0.5 to 1.2) for the control, 0.8 (0.4 to 1.1) for the information-only, 0.7 (0.3 to 1.1) for the gain-of-reward, and 1.3 (0.4 to 2.2) for the loss-of-reward group at the start of intervention. During the intervention phase, the loss-of-reward group with 0.6 (0.5 to 0.7) had the lowest mean of S10 + rate, followed by the gain-of-reward group with 0.8 (0.7 to 0.8). The loss-of-reward and gain-of-reward groups were the most influenced groups by the intervention, with 38.0% (13.2 to 55.7; p-value < 0.01) and 29.4% (2.0 to 49.2; p-value = 0.04) less S10 + rate than the control group, respectively. It was figured out that providing information regarding drivers' behavior without appropriating motives or penalties would have a minuscule impact.In addition, the group of drivers who were treated with instant punishment was the most influenced group by the intervention.

Effects of real-time feedback on functional ROM and loading rate during downhill walking on an instrumented treadmill

Effects of real-time feedback on functional ROM and loading rate during downhill walking on an instrumented treadmill

Abstract 11441: The Smarter Weight Loss Intervention Trial: The Effect of Real-Time Feedback on Weight Loss at 12-Months

Introduction: Obesity prevalence exceeds 40%, yet availability of standard behavioral treatment to those with overweight/obesity is limited; moreover, its in-person format and intensity is unappealing to some. Evidence indicates that providing feedback (FB) to self-monitoring (SM) of lifestyle behaviors improves outcomes. We tested the efficacy of delivering tailored FB messages remotely compared to no FB on weight loss outcomes. Hypothesis: At 12 mos participants receiving feedback (SM+FB) would have greater weight loss than those in the SM only group. Methods: We randomized 502 adults with overweight/obesity to either SM+FB (n=251) or SM alone (n=251). We delivered 3 smartphone pop-up messages/day to SM+FB group that were tailored to SM entries and delivered at random during waking hours. SM tools included a smartphone app to self-report diet, Fitbit Charge 2 to monitor physical activity, and a digital scale to track weight. All had a 90-min 1:1 intervention session with a dietitian at baseline that focused on behavioral changes to achieve weight loss. Percent weight loss from baseline and percentage of participants having ≥5% weight loss at 12 mos were compared between treatment groups using an intention-to-treat approach. Missing assessment weights at 12 mos were imputed using participants’ weight tracking data. Results: The sample was mostly female (79.5%) and white (84.3%) with a mean BMI of 33.1 ± 3.93 kg/m 2 . Based on the linear mixed modeling of weight, only a significant time main effect was observed ( F = 61.43, P &lt;.0001), suggesting that on average there was significant change in weight over the 12-month period. Both groups had similar percent weight loss at 12 mos, SM+FB group: mean [95% CI] -2.12% [-3.04, -1.20] and SM group: -2.39% [-3.32, -1.47] (P= .679). The percentage achieving ≥5% weight loss at 12 mos was also similar between the groups (26.3% for the SM+FB group and 29.1% for the SM group) (P= 0.485). Conclusions: The results did not support our hypothesis that participants in the SM+FB group would show greater weight loss at 12 mos than those in the SM group; however, the data support clinical efficacy for both approaches to a weight loss intervention.

Effects of real-time feedback during decline walking on kinematic and kinetic gait parameters in a healthy population: study protocol for a randomized trial\xa0\u2014\xa0up and down

BackgroundThe control of the dynamic functional leg alignment (dFLA) and biomechanical load are important joint-related aspects regarding the development of osteoarthritis (OA). Research on level walking with feedback on load-related parameters has provided innovative treatment possibilities. With regard to walking on sloped surfaces, fundamental biomechanical knowledge exists. However, comprehensive data on the agreement of kinematics and kinetics of self-paced ramp versus sloped treadmill walking is lacking. Further, deeper insights into the control of the dFLA during decline walking and the usefulness of real-time feedback are missing.Methods/designThirty healthy participants aged between 18 and 35 years will be included. They will complete a three-dimensional gait analysis walking self-paced up and down on a 5-m ramp with a 10° inclination. Subsequently, speed-matched to ramp-up walking and self-paced 10° incline split-belt treadmill walking will be assessed. Afterwards, the participants will be observed under four different conditions of 10° declined walking on the same treadmill (a) self-paced walking, (b) self-paced walking with an internal focus of attention, (c) self-paced walking with real-time feedback, and (d) condition c speed-matched walking. The primary outcome parameter will be the frontal knee range of motion (fKROM). Secondary outcomes include the ground reaction force loading rate, spatial-temporal parameters, as well as sagittal, frontal and transversal kinematics, and kinetics for the lower extremities.DiscussionThe findings aim at improving the understanding of the effects of real-time feedback on the control of the dFLA and lower limb loading. Following clinical practicable methods for effective feedback devices can be developed and evaluated. Additionally, the first dataset comparing kinematic and kinetic parameters for decline and incline ramp walking versus walking on an instrumented treadmill will be available for appropriate intervention planning.Trial registrationClinicalTrials.govNCT04763850. Prospectively registered on 21 February 2021.

Interactive online skin cancer training game “Whack-a-Mole” assesses training strategies and real-time feedback on melanoma identification among U.S. adults.

10564 Background: Cutaneous melanoma is a deadly form of skin cancer. Several studies have shown that early melanoma detection is associated with decreased mortality through self-examination and dermatology full-body skin exams. ABCD rule and the ugly duckling sign (UDS) are used to identify melanomas, but little research has explored the comparative efficacy of these approaches. This investigation compares the effectiveness of different mole identification training strategies and explores the effect of real-time feedback on decision-making. Methods: We developed an online melanoma identification game that tests differences between training types and expert feedback on mole identification. This online RCT tests a 4 (training: ABCD, UDS, both, control) X 3 (feedback: standard, motivational, control) factorial design on melanoma identification, skin cancer beliefs (perceived susceptibility and self-efficacy), and skin cancer prevention intentions. Standard feedback included expert evaluations of moles, whereas motivational feedback added statements grounded in fear appeals theory to encourage skin self-examination. An online research panel service was used to recruit 1025 US adults. Participants were randomly assigned to condition, completed a pretest, participated in the game intervention, and completed a posttest. Gameplay incorporates the same mechanics as Tinder (swipe left on benign moles and swipe right on malignant moles). Results: In total, participants reviewed 48 moles, 12 of which were melanomas. We used two-way ANCOVA for the analysis. ABCD training resulted in significantly higher melanoma identification than the control ( p =.011). Every training type resulted in significantly higher self-efficacy than the control ( p =.007). Additionally, there was a significant main effect of feedback on self-efficacy ( p =.001), where both standard and motivational feedback elicited significantly higher levels of self-efficacy than the control condition. Around 88% of participants intend to conduct skin self-exams and wear sunscreen. Conclusions: Our data suggests that “Whack a Mole” is an efficacious tool for melanoma training. ABCD and UDS training with interactive feedback are important to improve accuracy and ability for melanoma identification.

Training public speaking with virtual social interactions: effectiveness of real-time feedback and delayed feedback

Social signal processing and virtual social interaction technologies have allowed the creation of social skills training applications, and initial studies have shown that such solutions can lead to positive training outcomes and could complement traditional teaching methods by providing cheap, accessible, safe tools for training social skills. However, these studies evaluated social skills training systems as a whole and it is unclear to what extent which components contributed to positive outcomes. In this paper, we describe an experimental study where we compared the relative efficacy of real-time interactive feedback and after-action feedback in the context of a public speaking training application. We observed that both components provide benefits to the overall training: the real-time interactive feedback made the experience more immersive and improved participants’ motivation in using the system, while the after-action feedback led to positive training outcomes when it contained personalized feedback elements. Taken in combination, these results confirm that both social signal processing technologies and virtual social interactions are both contributing to social skills training systems’ efficiency. Additionally, we observed that several individual factors, here the subjects’ initial level of public speaking anxiety, personality and tendency to immersion significantly influenced the training experience. This finding suggests that social skills training systems could benefit from being tailored to participants’ particular individual circumstances.

Impacts of chest compression cycle length and real-time feedback with a CPRmeter\xae on chest compression quality in out-of-hospital cardiac arrest: study protocol for a multicenter randomized controlled factorial plan trial

BackgroundWith a survival rate of 6 to 11%, out-of-hospital cardiac arrest (OHCA) remains a healthcare challenge with room for improvement in morbidity and mortality. The guidelines emphasize the highest possible quality of cardiopulmonary resuscitation (CPR) and chest compressions (CC). It is essential to minimize CC interruptions, and therefore increase the chest compression fraction (CCF), as this is an independent factor for survival. Survival is significantly and positively correlated with the suitability of CCF targets, CC frequency, CC depth, and brief predefibrillation pause. CC guidance improves adherence to recommendations and allows closer alignment with the CC objectives. The possibility of improving CCF by lengthening the time between two CC relays and the effect of real-time feedback on the quality of the CC must be investigated.MethodsUsing a 2 × 2 factorial design in a multicenter randomized trial, two hypotheses will be tested simultaneously: (i) a 4-min relay rhythm improves the CCF (reducing the no-flow time) compared to the currently recommended 2-min relay rate, and (ii) a guiding tool improves the quality of CC. Primary outcomes (i) CCF and (ii) correct compression score will be recorded by a real-time feedback device. Five hundred adult nontraumatic OHCAs will be included over 2 years. Patients will be randomized in a 1:1:1:1 distribution receiving advanced CPR as follows: 2-min blind, 2 min with guidance, 4-min blind, or 4 min with guidance. Secondary outcomes are the depth, frequency, and release of CC; length (care, no-flow, and low-flow); rate of return of spontaneous circulation; characteristics of advanced CPR; survival at hospital admission; survival and neurological state on days 1 and 30 (or intensive care discharge); and dosage of neuron-specific enolase on days 1 and 3.DiscussionThis study will contribute to assessing the impact of real-time feedback on CC quality in practical conditions of OHCA resuscitation. It will also provide insight into the feasibility of extending the relay rhythm between two rescuers from the currently recommended 2 to 4 min.Trial registrationClinicalTrials.gov, NCT03817892. Registered on 28 January 2019

The effect of real-time feedback on learning lumbar spine joint mobilization by entry-level doctor of physical therapy students: a randomized, controlled, crossover trial

ABSTRACT Objective To examine the effects of real-time, objective feedback on learning lumbar spine joint mobilization techniques by entry-level Doctor of Physical Therapy (DPT) students. Methods A randomized, controlled, crossover design was used. Twenty-four 1st Year DPT students were randomized into two groups. Group 1 (n = 12) practiced with the real-time feedback device first and then without it, while Group 2 (n = 12) practiced without the device first and then with it. Both practice periods with and without the device were 4 weeks long. Data were collected at Baseline, 5 weeks, 11 weeks, and 16 weeks. The crossover period was 5 weeks long, during which neither group practiced with or without the device. Eight force parameters were measured: R1 force; R2 force; Grade III and Grade IV mean peak force, frequency, and amplitude. Results When students practiced with the real-time feedback device, they more closely matched the reference standard for two outcomes: 1) the mean difference in R2 force between student and reference standard was better with device (38.0 ± 26.7 N) than without it (51.0 ± 38.5 N); P = .013; and 2) the mean difference in Grade III peak to peak amplitude force was also better with device (8.9 ± 9.3 N) than without it (11.8 ± 11.0); P = .026. All other force parameters improved when students practiced with the real-time feedback device, however, the differences between when they practiced without the device were not statistically significant. Discussion Real-time, objective feedback using a direct force measurement device improved learning for some aspects of lumbar spine joint mobilization by entry-level physical therapy students. Level of Evidence 2b

Effects of Real-Time Feedback Assisted Self-Correction on the Posture of Scoliotic Patients

Effects of Real-Time Feedback Assisted Self-Correction on the Posture of Scoliotic Patients

Effect of real-time feedback during cardiopulmonary resuscitation training on quality of performances: A prospective cluster-randomized trial

Background: The evidence supporting delivery of quality cardiopulmonary resuscitation is growing and significant attention has been focused on improving bystander cardiopulmonary resuscitation education for laypeople. The aim of this randomized trial was to assess the effectiveness of instructor’s real-time objective feedback during cardiopulmonary resuscitation training compared to conventional feedback in terms of trainee’s cardiopulmonary resuscitation quality. Methods: We performed a cluster-randomized trial of community cardiopulmonary resuscitation training classes at Nowon District Health Community Center in Seoul. Cardiopulmonary resuscitation training classes were randomized into either intervention (instructor’s objective real-time feedback based on the QCPR Classroom device) or control (conventional, instructor’s judgment-based feedback) group. The primary outcome was total cardiopulmonary resuscitation score, which is an overall measure of chest compression quality. Secondary outcomes were individual cardiopulmonary resuscitation performance parameters, including compression rate, depth, and release. Generalized linear mixed models were used to analyze the outcome data, accounting for both random and fixed effects. Results: A total of 149 training sessions (2613 trainees) were randomized into 70 intervention (1262 trainees) and 79 control (1351 trainees) groups. Trainees in the QCPR feedback group significantly increased overall cardiopulmonary resuscitation score performance compared with those in the conventional feedback group (model-based mean Δ increment from baseline to session 5: 11.2 (95% confidence interval 9.2–13.2) and 8.0 (6.0–9.9), respectively; p = 0.02). Individual parameters of compression depth and release also showed higher improvement among trainees in QCPR group with positive trends (p &lt; 0.08 for both). Conclusion: This randomized trial suggests beneficial effect of instructor’s real-time objective feedback on the quality of layperson’s cardiopulmonary resuscitation performance.

The Effect of Real-Time Feedback on Vertical Oscillation and Running Economy

The Effect of Real-Time Feedback on Vertical Oscillation and Running Economy

The Effect of Real-Time Feedback Using a Smartwatch on the Clinical Behavior of Novice Student Clinicians

The use of computer monitors to provide technology-based written feedback during clinical sessions, referred to as “bug-in-the-eye” (BITi) feedback, recently emerged in the literature with preliminary evidence to support its effectiveness (Carmel, Villatte, Rosenthal, Chalker &amp; Comtois, 2015; Weck et al., 2016). This investigation employed a single-subject, sequential A-B design with two participants to observe the effects of implementing BITi feedback using a smartwatch on the clinical behavior of student clinicians (SCs). Baseline and treatment data on the stimulus-response-consequence (S-R-C) contingency completion rates of SCs were collected using 10 minute segments of recorded therapy sessions. All participants were students enrolled in a clinical practicum experience in a communication disorders and sciences (CDS) program. A celeration line, descriptive statistics, and stability band were used to analyze the data by slope, trend, and variability. Results demonstrated a significant correlative relationship between BITi feedback with a smartwatch and an increase in positive clinical behaviors. Based on qualitative interviews and exit rating scales, SCs reported BITi feedback was noninvasive and minimally distracting. Preliminary evidence suggests BITi feedback with a smartwatch may be an effective tool for providing real-time clinical feedback.

Very brief training for laypeople in hands-only cardiopulmonary resuscitation. Effect of real-time feedback

BackgroundBystander cardiopulmonary resuscitation (CPR) improves survival from out-of-hospital cardiac arrest, but rates and performance quality remain low. Although training laypeople is a primary educational goal, the optimal strategy is not well defined. This study aimed to determine whether a short training with real-time feedback was able to improve hands-only CPR among untrained citizens. MethodsOn the occasion of the 2015 World Heart Day and the European Restart a Heart Day, a pilot study involving 155 participants (81 laypeople, 74 health care professionals) was conducted. Participants were invited to briefly practice hands-only CPR on a manikin and were after evaluated during a 2-minute chest compression (CC) test. During training brief instructions regarding hand position, compression rate and depth according to the current guidelines were given and real-time feedback was provided by a Laerdal SkillReporting System. ResultsMean CC rate was significantly higher among health care professionals than among laypeople (119.07 ± 12.85 vs 113.02 ± 13.90 min−1; P = .006), although both met the 100-120 CC min−1 criterion. Laypeople achieved noninferior results regarding % of CC at adequate rate (51.46% ± 35.32% vs health care staff (55.97% ± 36.36%; P = .43) and depth (49.88% ± 38.58% vs 50.46% ± 37.17%; P = .92), % of CC with full-chest recoil (92.77% ± 17.17% vs 0.91% ± 18.84; P = .52), and adequate hand position (96.94% ± 14.78% vs 99.74 ± 1.98%; P = .11). The overall quality performance was greater than 70%, noninferior for citizens (81.23% ± 20.10%) vs health care staff (85.95% ± 14.78%; P = .10). ConclusionWith a very brief training supported by hands-on instructor-led advice and visual feedback, naïve laypeople are able to perform good-quality CC-CPR. Simple instructions, feedback, and motivation were the key elements of this strategy, which could make feasible to train big numbers of citizens.

The effect of real-time feedback on velocity fluctuations in steady state rowing

Rowing performance depends on maximization of mechanical power delivered by the rower(s) and minimization of power losses [1]. Though reductions of power losses may increase the average velocity of a boat, traditional feedback methods lack the accuracy to differentiate between small variations in this power losses. Therefore, we developed a feedback tool to provide real-time feedback about power parameters related to rowing. The current study evaluated the efficacy-with respect to velocity fluctuation power losses-of the real-time feedback on the power loss due to velocity fluctuations compared to the efficacy of traditional feedback.

Immediate effects of real-time feedback on jump-landing kinematics.

Randomized controlled trial. To determine if the addition of real-time feedback (RTF) to postresponse feedback (PRF) improves jump-landing kinematics compared to PRF alone and a no-feedback control group. Injury-prevention programs to reduce risk of anterior cruciate ligament injury have shown promising results in altering jump-landing biomechanics. Real-time feedback provided during the task may allow participants to more easily understand and execute new movement strategies compared to PRF provided after the task is completed. Thirty-six healthy females were randomized to 1 of 3 groups: RTF plus PRF, PRF, or control. Sagittal plane moments and angles at the knee and hip, frontal plane angles at the knee, and vertical ground reaction forces during a jump-landing task were quantified at baseline and postintervention. The RTF plus PRF and PRF groups received a PowerPoint presentation containing the goals of correct landing technique. In addition to the PowerPoint presentation, the RTF plus PRF group was provided real-time visualization of their frontal plane knee angle. Participants in the control group performed the jump-landing task without feedback. Posttraining, the RTF plus PRF and PRF groups demonstrated similar improvements in hip and knee flexion and decreased vertical ground reaction forces compared to the control group. There were no changes in frontal plane knee kinematics between groups posttraining. The addition of RTF to PRF did not result in significant changes in jump-landing kinematics compared to PRF alone. Prevention, level 5.

A Randomised, Cross over Study Using a Mannequin Model to Evaluate the Effects on CPR Quality of Real-Time Audio-Visual Feedback Provided by a Smartphone Application

Objective To evaluate the effect of real time feedback provided by smartphone application on cardiopulmonary resuscitation (CPR) performance. Methods Participants were randomised in two groups based on whether chest compression with or without the assistance of the smartphone application. Both groups performed hands-only CPR on a mannequin for 4 minutes. Data on CPR performance of both groups was compared. To assess the reliability the feedback value, we compared the CPR data from Skillmeter and data from smartphone. A questionnaire survey to participants about the usefulness of the application was also evaluated. Results Twenty-one subjects were recruited for the study. We found no significant difference in mean chest compression rate (103.3±5.0/min vs. 107.1±1.7/min; p=0.133) and depth between the two groups (47.3 [39.3, 56.2] mm vs. 45.8 [40.3, 49.9] mm; p=0.085). The proportion of adequate compression depth over the total compression was significantly higher in the group using the smartphone (38.1% vs. 22.2%; p=0.034). The CPR data displayed on smartphone application in mannequin's chest was not different from Skillmeter software. The majority of the participants considered the application easy to use, but holding the smartphone during CPR hampered compression. Conclusions Real-time audio-visual feedback on CPR depth and rate using a smartphone application can help to maintain the adequate chest compression depth in prolonged CPR. A better method to hold the smartphone may maximise the feedback effect on CPR quality. (Hong Kong j.emerg.med. 2014;21:153-160)

Effect of real-time feedback during cardiopulmonary resuscitation outside hospital: prospective, cluster-randomised trial

Objective To investigate whether real-time audio and visual feedback during cardiopulmonary resuscitation outside hospital increases the proportion of subjects who achieved prehospital return of spontaneous circulation.Design A cluster-randomised trial.Subjects 1586...