Arm Training Research Articles

Evaluation of training in guideline-oriented biopsychosocial management of low back pain in occupational health services: Protocol of a cluster randomized trial.

BackgroundTo prevent low back pain (LBP) from developing into a prolonged disabling condition, clinical guidelines advocate early stage assessment, risk‐screening, and tailored interventions. Occupational health services recommend guideline‐oriented biopsychosocial screening and individualized assessment and management. However, it is not known whether training a limited number of health care professionals improves the management process. The primary objective of this study is to investigate whether training in the biopsychosocial practice model is effective in reducing disability. Furthermore, we aim to evaluate health‐economic impacts of the training intervention in comparison to usual medical care.MethodsThe occupational health service units will be allocated into a training or control arm in a two‐arm cluster randomized controlled design. The training of occupational physiotherapists and physicians will include the assessment of pain‐related psychosocial factors using the STarT Back Tool and the short version of the Örebro Musculoskeletal Pain Screening Questionnaire, the use of an evidence‐based patient education booklet as part of the management of LBP, and tailored individualized management of LBP according to risk stratification. The control units will receive no training. The study population will include patients aged 18–65 with nonspecific LBP. The primary outcome is a patient‐reported Oswestry Disability Index from baseline to 12 months. By estimating group differences over time, we aim to evaluate the effectiveness of the training intervention in comparison to usual medical care, and to undertake an economic evaluation using individual patients' health care records (participant‐level data) and the participating units' registries (cluster‐level data). In addition, through interviews and questionnaires, we will explore the health care professionals' conceptions of the adoption of, the barriers to, and the facilitators of the implementation of the practice model.DiscussionThe evaluation of training in the guideline‐oriented biopsychosocial management of LBP in occupational health services is justified because LBP represents an enormous burden in terms of work disability.

Impact of structured simulation-based and on-job training program on nurses' competency in pediatric peripheral intravenous cannulation: Children's hospital experience

BackgroundPeripheral intravenous cannulation (PIVC) is a frequent invasive, painful procedure in children. Nursing education and competency are of great importance to decrease complications. Objectivesto evaluate the impact of structured simulation-based PIVC training and on-job assessment program on nurses' knowledge, attitudes, and performance. DesignSettings/participants: A prospective, structured, competency improvement training, assessment, feedback, and reassessment conducted on 150 pediatric nurses. They provided nursing care for in-patients at the newly open Children's hospital, Ain Shams University.Methods: PIVC insertion skills and care knowledge, structured simulation-based mannequin training arm venipuncture model and on-job assessment were conducted. In the preparatory phase, 15 nurses were interviewed to develop the assessment tools. Knowledge and attitudes were assessed quantitatively using a validated self-administered questionnaire. Structured simulation-based training, and on-job skill assessment were performed using validated observer checklist. Assessment performed at enrollment (baseline), immediate post training, and reassessment 2-months after the training, using same tools. ResultsKnowledge, performance, and attitudes were significantly improved for the 150 trained nurses. There was improvement in immediate post training assessment than the reassessment after 2-months, compared to baseline for total knowledge score; peripheral cannula insertion score; hand washing before aseptic procedure; skin antisepsis at puncture site; no puncture site palpation after disinfection; apply sterile dressing to puncture site, p = 0.00, respectively.There was improvement in the reassessment after 2-months than post training assessment, compared to baseline for the total attitude score, p = 0.02; peripheral cannula care, p = 0.00; aseptic technique, p = 0.00; wearing protective gloves, p = 0.01; total practice score, p = 0.00.Years of experience, last 6-months training course, practice level, educational level, age, and attitude influence overall performance. ConclusionsStructured simulation-based training and on-job skill assessment are effective for improvement of PIVC insertion and care. Continuous education, feedback, assessment/reassessment, and monitoring should be recommended to retain the gained improvement in attitudes, knowledge, and skills. Changing workplace structure and improve work environment should be studied as factors that might affect learning.

A self-aligning end-effector robot for individual joint training of the human arm.

AimIntense training of arm movements using robotic devices can help reduce impairments in stroke. Recent evidence indicates that independent training of individual joints of the arm with robots can be as effective as coordinated multi-joint arm training. This makes a case for designing and developing robots made for training individual joints, which can be simpler and more compact than the ones for coordinate multi-joint arm training. The design of such a robot is the aim of the work presented in this paper.MethodsAn end-effector robot kinematic design was developed and the optimal robot link lengths were estimated using an optimization procedure. A simple algorithm for automatically detecting human limb parameters is proposed and its performance was evaluated through a simulation study.ResultsA six-degrees-of-freedom end-effector robot with three actuated degrees-of-freedom and three non-actuated self-aligning degrees-of-freedom for safe assisted training of the individual joints (shoulder or elbow) of the human arm was conceived. The proposed robot has relaxed constraints on the relative positioning of the human limb with respect to the robot. The optimized link lengths chosen for the robot allow it to cover about 80% of the human limb’s workspace, and possess good overall manipulability. The simple estimation procedure was demonstrated to estimate human limb parameters with low bias and variance.DiscussionThe proposed robot with three actuated and three non-actuated degrees-of-freedom has a compact structure suitable for both the left and right arms without any change to its structure. The proposed automatic estimation procedure allows the robot to safely apply forces and impose movements to the human limb, without the need for any manual measurements. Such compact robots have the highest potential for clinical translation

Analysis of Military Training Security Risk Assessment Method Based on F-ANP

Combining the arm training practice after the Strong Army Reform, this paper put forwards using the F-ANP method for military training security risks to semi- quantitative evaluation, builds the safety risk assessment index system of military training, semi-quantitative calculation and analysis, and put forwards the opinions of the security risk prevention and control suggestions. This paper enriches the military training of security risk assessment methods, and provides the reference to the research of military training safety risk assessment.

EFFICACY OF BILATERAL ARM TRAINING ON UPPER LIMB MOTOR FUNCTION IN STROKE PATIENTS

Background of the study: Stroke is the leading cause of adult disability. Stroke patients experience a significant change in motor function. Perceived loss of hand function has been reported as a major problem in approximately 65% of patients with stroke. Motor dysfunction of upper extremity which indeed affects functional performance of daily life is an outcome of stroke. So restriction of motor function is highly relevant for stroke patients to make them functionally independent. Stroke rehabilitation needs to concentrate on retraining techniques which are simple, affordable and effective. Objectives of the study: The objective of the study is to find the effects of bilateral arm training in the management of upper limb motor function in stroke patients.

Effect of Different Forms of Activity-Based Recovery Training on Bladder, Bowel, and Sexual Function After Spinal Cord Injury

ObjectivesTo investigate whether the urogenital and bowel functional gains previously demonstrated post-locomotor step training after chronic spinal cord injury could have been derived due to weight-bearing alone or from exercise in general. DesignProspective cohort study; pilot trial with small sample size. SettingUrogenital and bowel scientific core facility at a rehabilitation institute and spinal cord injury research center in the United States. ParticipantsMen and women (N=22) with spinal cord injury (American Spinal Injury Association Impairment Scale grades of A-D) participated in this study. InterventionsApproximately 80 daily 1-hour sessions of either stand training or nonweight-bearing arm crank ergometry. Comparisons were made with previously published locomotor training data (step; N=7). Main Outcome MeasuresAssessments at both pre- and post-training timepoints included cystometry for bladder function and International Data Set Questionnaires for bowel and sexual functions. ResultsCystometry measurements revealed a significant decrease in bladder pressure and limited improvement in compliance with nonweight-bearing exercise but not with standing. Although International Data Set questionnaires revealed profound bowel dysfunction and marked deficits in sexual function pretraining, no differences were identified poststand or after nonweight-bearing exercise. ConclusionsThese pilot trial results suggest that, although stand and weight-bearing alone do not benefit pelvic organ functions after spinal cord injury, exercise in general may contribute at least partially to the lowering of bladder pressure and the increase in compliance that was seen previously with locomotor training, potentially through metabolic, humoral, and/or cardiovascular mechanisms. Thus, to maximize activity-based recovery training benefits for functions related to storage and emptying, an appropriate level of sensory input to the spinal cord neural circuitries controlling bladder and bowel requires task-specific stepping.

Efficacy of Visual Retraining in the Hemianopic Field after Stroke: Results of a Randomized Clinical Trial

To evaluate the efficacy of motion discrimination training as a potential therapy for stroke-induced hemianopic visual field defects. Clinical trial. Forty-eight patients with stroke-induced homonymous hemianopia (HH) were randomized into 2 training arms: intervention and control. Patients were between 21 and 75 years of age and showed no ocular issues at presentation. Patients were trained on a motion discrimination task previously evidenced to reduce visual field deficits, but not in a randomized clinical trial. Patients were randomized with equal allocation to receive training in either their sighted or deficit visual fields. Training was performed at home for 6 months, consisting of repeated visual discriminations at a single location for 20 to 30 minutes daily. Study staff and patients were masked to training type. Testing before and after training was identical, consisting of Humphrey visual fields (Carl Zeiss Meditech), macular integrity assessment perimetry, OCT, motion discrimination performance, and visual quality-of-life questionnaires. Primary outcome measures were changes in perimetric mean deviation (PMD) on Humphrey Visual Field Analyzer in both eyes. Mean PMDs improved over 6 months in deficit-trained patients (mean change in the right eye, 0.58 dB; 95% confidence interval, 0.07-1.08 dB; mean change in the left eye 0.84 dB; 95% confidence interval, 0.22-1.47 dB). No improvement was observed in sighted-trained patients (mean change in the right eye, 0.12 dB; 95% confidence interval, -0.38 to 0.62 dB; mean change in the left eye, 0.10 dB; 95% confidence interval, -0.52 to 0.72 dB). However, no significant differences were found between the alternative training methods (right eye, P= 0.19; left eye, P= 0.10). To date, no widely accepted therapy is available to treat HH. This study evaluated the efficacy of a promising potential treatment, visual perceptual training. We failed to find a difference between treatment training within the deficit field and control training within the sighted field when performed in a home environment.

Magnetic needle-tracking device for ultrasound guidance of radial artery puncture: A randomized study on a simulation model.

Ultrasound-guidance of radial artery catheter insertion improves the first attempt success and reduces the occurrence of hematomas. Needle-tracking devices optimize needle-ultrasound beam alignment by displaying in real-time the needle tip position. We compared the median time need by experienced physicians to achieve radial artery puncture using either a conventional ultrasonography device (CUD) or a magnetic needle-tracking ultrasound device (MUD) in a simulation training arm model. Fifty experienced residents and physicians performed two punctures in randomized order with the CUD and the MUD. The primary outcome was puncture duration; the secondary outcomes were puncture success, rate of accidental vein puncture, and practitioner's comfort (subjective scale 0-10). The median [lower-upper quartile] puncture time was 10 [6-14] seconds when using CUD and 4 [3-7] seconds when using MUD (P < .01). In the multivariate analysis, MUD use was associated with decreased puncture duration whatever the puncture order (OR 1.13 [1.07-1.20], P < .01). The participants performed 99 (99%) successful punctures: 50 with the MUD (100%) and 49 with the CUD (98%). There was no accidental venous puncture. The practitioner's comfort level was 6.5 [6, 7] with the CUD and 8 [7-9] with the MUD (P < .01). MUD reduced radial artery puncture time and improved physician comfort in a simulation training arm model.

The modulatory effects of bilateral arm training (BAT) on the brain in stroke patients: a systematic review.

To systematically review the modulatory effects of bilateral arm training (BAT) on the brain of stroke patients in contrast to unilateral arm training (UAT) or regular motor training. We conducted a literature search using PubMed, EMBASE, MEDLINE, and Science Citation Index Expanded databases from the inception to March 2019 for identifying any relevant studies. Two authors independently screened the literature, extracted data, and qualitatively described the included studies. Eleven studies with a total of 225 stroke patients were included in this review. 156 out of those participants received neuroimaging or neurophysiological examinations. Six studies reported enhanced activation of the ipsilesional primary motor area (M1) induced by BAT, as measured by MEP and fMRI. Beyond the M1, three studies showed that supplementary motor area (SMA) was activated, and three studies found the primary sensory cortex area (S1) was activated by BAT in stroke patients, as measured by fMRI. One article showed that the inter-/intra-hemispheric functional connections of the sensorimotor network were more highly strengthened after BAT than regular motor training, in particular the functional connectivity between the SMA and the M1 in the bi-hemispheres. Three studies reported that BAT increased the inhibitory flow from the ipsilesional hemisphere to the contralesional hemisphere, as measured by interhemispheric transcallosal inhibition (IHI). However, the superiority of BAT in inducing a symmetric IHI than UAT was controversial. BAT is potentially more effective than UAT in improving upper limb recovery after stroke by activating the ipsilesional primary motor area (M1), supplementary motor area (SMA), and primary sensory cortex (S1) and enhancing the intra-hemispheric and interhemispheric connectivity within the sensorimotor network and the cortical motor system.

Effects of bilateral arm training on upper extremity function in right and left hemispheric stroke.

This experimental study on 24 stroke patients aimed at evaluating and comparing the effects of bilateral arm training on upper extremity (UE) motor function between right and left hemispheric chronic stroke patients. Both groups received the same intervention involving 5 functional tasks for 1 hour, 3 days per week, for a total of 6 weeks. Fugl-Meyer Assessment-Upper Extremity and Wolf-Motor Function Test were applied as outcome measures at baseline and after 6 weeks of training to assess the recovery of function in the affected area. Intra-group analysis showed no significant improvement in the wrist and hand function in the left hemispheric stroke (LHS) (p>0.05), while right hemispheric stroke (RHS) patients did not improve significantly in the coordination/speed domain (p>0.05). Inter-group analysis showed no significant difference between right and left hemispheric stroke patients (p>0.05). Bilateral arm training showed beneficial effects in improving UE function in both RHS and LHS patients. Distal UE function in LHS and coordination and speed of movement in RHS patients did not show any significant improvement.

Robot-Assisted Arm Training versus Therapist-Mediated Training after Stroke: A Systematic Review and Meta-Analysis.

Background More than two-thirds of stroke patients have arm motor impairments and function deficits on hospital admission, leading to diminished quality of life and reduced social participation. Robot-assisted training (RAT) is a promising rehabilitation program for upper extremity while its effect is still controversial due to heterogeneity in clinical trials. We performed a systematic review and meta-analysis to compare robot-assisted training (RAT) versus therapist-mediated training (TMT) for arm rehabilitation after stroke. Methods We searched the following electronic databases: MEDLINE, EMBASE, Cochrane EBM Reviews, and Physiotherapy Evidence Database (PEDro). Studies of moderate or high methodological quality (PEDro score ≥4) were included and analyzed. We assessed the effects of RAT versus TMT for arm rehabilitation after stroke with testing the noninferiority of RAT. A small effect size of −2 score for mean difference in Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) and Cohen's d = −0.2 for standardized mean difference (SMD) were set as noninferiority margin. Results Thirty-five trials with 2241 participants met inclusion criteria. The effect size for arm motor impairment, capacity, activities of daily living, and social participation were 0.763 (WMD, 95% CI: 0.404 to 1.123), 0.109 (SMD, 95% CI: −0.066 to 0.284), 0.049 (SMD, 95% CI: −0.055 to 0.17), and −0.061 (SMD, 95% CI: −0.196 to 0.075), respectively. Conclusion This systematic review and meta-analysis demonstrated that robot-assisted training was slightly superior in motor impairment recovery and noninferior to therapist-mediated training in improving arm capacity, activities of daily living, and social participation, which supported the use of RAT in clinical practice.

Kronik İnmeli Hastalarda Ritmik İşitsel Uyarı İle Bilateral Kol Eğitim Tedavisinin Üst Ekstremite Fonksiyonlarına ve Günlük Yaşam Aktivitelerine Etkisinin Araştırılması

Amaç: Bu çalışma ile kronik inmeli hastalarda uygulanan ritmik işitsel uyarı ile bilateral kol eğitiminin (RİUBKE) üst ekstremite fonksiyonları, günlük yaşam aktivitelerine katılım ve ağrı üzerine etkilerinin incelenmesi amaçlanmıştır. Yöntem: Randomize kontrollü bu çalışmaya 28 hasta dahil edildi. Hastalar RİUBKE (n=15) ve kontrol (n=13) olarak iki gruba ayrıldı. Tüm hastaların demografik verileri, Brunnstrom evreleri, Modifiye Ashworth Skalası (MAS) ve ağrı düzeyleri kaydedildi. Hastaların tümü 3 hafta süreyle konvansiyonel terapi programına alındı. Ek olarak RİUBKE grubundaki hastalara, RİUBKE cihazı ile haftanın 5 günü 3 hafta süreyle bilateral üst ekstremite eğitimi uygulandı. Plejik üst ekstremite motor fonksiyonları Jebsen Taylor El Fonksiyon Testi (JTEFT) ve Box and Block Test (BBT) ile, günlük yaşam aktiviteleri Modifiye Barthel İndeks (MBİ) ile, ağrı düzeyleri Görsel Analog Skala (GAS) ile Tüm değerlendirmeler tedavi öncesi ve tedaviden 3 hafta sonra değerlendirildi. Tüm veriler Mann Whitney U testi ve Wilcoxon testi kullanılarak analiz edildi. Bulgular: BBT ve JTEFT’in bazı parametrelerinde (sayfa çevirme, büyük ağır obje kaldırma ve tavla pulu dizme) (p&amp;lt;0,05, tüm parametreler) gelişme kaydedildi. MBİ ve GAS parametrelerinde istatiksel olarak anlamlı fark saptanmadı (p&amp;gt;0,05). Sonuç: RİUBKE ile üst ekstremite bilateral eğitiminin kronik inmeli hastalarda üst ekstremite fonksiyonları üzerine etkili olduğu kanaatine varıldı. Alınan bu sonuçlar inme rehabilitasyonunda RİUBKE ile bilateral eğitimin konvansiyonel tedavilerle birlikte kullanılabileceğini düşündürmektedir.

비우성팔 트레이닝이 남자 대학골프선수의 최대근력과 아이언 샷 관련 변인에 미치는 영향

[목적] 본 연구는 두 팔 중 상대적으로 근력이 약한 비우성팔의 근력향상 트레이닝 프로그램 중재가 대학골프선수의 1RM 근력 및 아이언 비거리 관련 요인에 미치는 영향을 관찰하여 효과적인 골프 트레이닝 방법을 제시하는데 있다. [방법] 본 연구에서는 남자 대학 골프선수 22명이 참여하였으며, 대조군과 운동군으로 각 11명씩 무선 할당하였다. 트 레이닝 강도 설정을 위해 트레이닝군의 1RM을 측정하여 70% 1RM으로 강도를 설정하였으며, 총 6가지 비우성팔 근력 향상 프로그램을 6주간 수행하였으며, 아이언비거리 관련 변인을 측정하였다. [결과] 트레이닝 적용 후 덤벨 컬, 트라이 셉스 익스텐션 1RM의 유의한 증가(p<0.05)가 관찰되었다. 또한 아이언 비거리 관련 변인 중 볼스피드와 비행거리에서 유의한 증가(p<0.05)가 관찰되었다. 그리고 상대적 리스트 컬 포워드의 1RM과 볼스피드에서 유의한 음의 상관관계를 확인하였다. [결론] 이 결과는 6주간의 비우성팔 근력향상 프로그램은 볼스피드와 비행거리에 긍정적인 영향을 미치지 만 더욱 효과적인 골프 트레이닝을 위해서는 트레이닝 프로그램의 기간 연장, 프로그램 구성 등을 고려해야 할 것이다.

Predicting clinically significant motor function improvement after contemporary task-oriented interventions using machine learning approaches

BackgroundAccurate prediction of motor recovery after stroke is critical for treatment decisions and planning. Machine learning has been proposed to be a promising technique for outcome prediction because of its high accuracy and ability to process large volumes of data. It has been used to predict acute stroke recovery; however, whether machine learning would be effective for predicting rehabilitation outcomes in chronic stroke patients for common contemporary task-oriented interventions remains largely unexplored. This study aimed to determine the accuracy and performance of machine learning to predict clinically significant motor function improvements after contemporary task-oriented intervention in chronic stroke patients and identify important predictors for building machine learning prediction models.MethodsThis study was a secondary analysis of data using two common machine learning approaches, which were the k-nearest neighbor (KNN) and artificial neural network (ANN). Chronic stroke patients (N = 239) that received 30 h of task-oriented training including the constraint-induced movement therapy, bilateral arm training, robot-assisted therapy and mirror therapy were included. The Fugl-Meyer assessment scale (FMA) was the main outcome. Potential predictors include age, gender, side of lesion, time since stroke, baseline functional status, motor function and quality of life. We divided the data set into a training set and a test set and used the cross-validation procedure to construct machine learning models based on the training set. After the models were built, we used the test data set to evaluate the accuracy and prediction performance of the models.ResultsThree important predictors were identified, which were time since stroke, baseline functional independence measure (FIM) and baseline FMA scores. Models for predicting motor function improvements were accurate. The prediction accuracy of the KNN model was 85.42% and area under the receiver operating characteristic curve (AUC-ROC) was 0.89. The prediction accuracy of the ANN model was 81.25% and the AUC-ROC was 0.77.ConclusionsIncorporating machine learning into clinical outcome prediction using three key predictors including time since stroke, baseline functional and motor ability may help clinicians/therapists to identify patients that are most likely to benefit from contemporary task-oriented interventions. The KNN and ANN models may be potentially useful for predicting clinically significant motor recovery in chronic stroke.

Targeted Engagement of the Action Selection Network during Task-Oriented Arm Training after Stroke.

Action selection (AS), or selection of an action from a set of alternatives, is an important movement preparation process that engages a frontal-parietal network. The addition of AS demands to arm training after stroke could be used to engage this motor planning process and the neural network that supports it. The purpose of this case series is to describe the feasibility and outcomes associated with task-oriented arm training aimed at engaging the AS behavioral process and the related neural network in three individuals with chronic stroke. Three participants with mild to moderate motor deficits completed 13 to 15 sessions of task-oriented arm training that included AS cues for each movement repetition; cues dictated movement direction, height, or distance. Before and after training, individuals completed an AS brain-behavior probe during functional MRI. AS behavioral performance improved after training (increased accuracy, decreased reaction time) in all participants while brain activation in the AS network (dorsal premotor, parietal, dorsolateral prefrontal cortices) decreased in two participants. Gains in motor function were also found in all three participants, especially on patient-reported measures of perceived difficulty and confidence to complete upper extremity functional tasks. It was feasible to target the AS behavioral process and the related neural network through the addition of AS demands to functional, task-oriented arm training in three individuals with mild to moderate motor dysfunction poststroke.

Contralateral effects of eccentric resistance training on immobilized arm.

This study compared the effects of contralateral eccentric-only (ECC) and concentric-/eccentric-coupled resistance training (CON-ECC) of the elbow flexors on immobilized arm. Thirty healthy participants (18-34 y) were randomly allocated to immobilization only (CTRL; n=10), immobilization and ECC (n=10), or immobilization and CON-ECC group (n=10). The non-dominant arms of all participants were immobilized (8h·day-1 ) for 4weeks, during which ECC and CON-ECC were performed by the dominant (non-immobilized) arm 3 times a week (3-6 sets of 10 repetitions per session) with an 80%-120% and 60%-90% of one concentric repetition maximum (1-RM) load, respectively, matching the total training volume. Arm circumference, 1-RM and maximal voluntary isometric contraction (MVIC) strength, biceps brachii surface electromyogram amplitude (sEMGRMS ), rate of force development (RFD), and joint position sense (JPS) were measured for both arms before and after immobilization. CTRL showed decreases (P<.05) in MVIC (-21.7%), sEMGRMS (-35.2%), RFD (-26.0%), 1-RM (-14.4%), JPS (-87.4%), and arm circumference (-5.1%) of the immobilized arm. These deficits were attenuated or eliminated by ECC and CON-ECC, with greater effect sizes for ECC than CON-ECC in MVIC (0.29: +12.1%, vs -0.18: -0.1%) and sEMGRMS (0.31:17.5% vs -0.15: -5.9%). For the trained arm, ECC showed greater effect size for MVIC than CON-ECC (0.47 vs 0.29), and increased arm circumference (+2.9%), sEMGRMS (+77.9%), and RDF (+31.8%) greater (P<.05) than CON-ECC (+0.6%, +15.1%, and+15.8%, respectively). The eccentric-only resistance training of the contralateral arm was more effective to counteract the negative immobilization effects than the concentric-eccentric training.

Effects of two different robot-assisted arm training on upper limb motor function and kinematics in chronic stroke survivors: A randomized controlled trial

ABSTRACT Background Comparative studies of different robotic types are warranted to tailor robot-assisted upper limb training to patient’s functional level. Objectives This study aimed to directly compare the effects of high inertia robot arm (whole arm manipulator, WAM) and low inertia robot arm (Proficio) on upper limb motor function in chronic stroke patients. Methods In this randomized controlled trial, 40 chronic stroke survivors were randomized into robot-assisted arm training with WAM (RAT-WAM) and robot-assisted arm training with Proficio (RAT-P) groups. The RAT-WAM and RAT-P groups participated in the robot-assisted arm training with WAM and robot-assisted arm training with Proficio, respectively, for 40 min daily, three times weekly over a four week. Upper limb motor function was measured before and after the intervention using the Fugl–Meyer assessment (FMA), action research arm test, and box and block test (BBT). Curvilinearity ratio (the length ratio of a straight line from the start to the target) was also measured as an index for upper limb kinematic performance. Results The RAT-WAM and RAT-P groups showed significant improvements in FMA-total and -proximal (shoulder/elbow units), BBT, and ARAT after the intervention (P < .05). Also, the RAT-P group showed significantly more improvement than the RAT-WAM group in FMA-distal (hand/wrist units) (P < .05). Conclusions Improvements of upper limb motor function occurred during robot-assisted arm training with robotic systems. Low inertia robot arm was more effective in improving the motor function of the hand and wrist. The results may be useful for robot-assisted training for upper limb impairment.

Web-Based Cognitive Training to Improve Working Memory in Persons with Co-Occurring HIV Infection and Cocaine Use Disorder: Outcomes from a Randomized Controlled Trial.

Neurocognitive impairment (NCI) remains a persistent complication of HIV disease that nearly half of persons with HIV experience, and rates are even higher in persons who use substances such as cocaine. Cognitive training is a promising intervention for HIV-associated NCI. In this randomized controlled trial, we examined the feasibility and effectiveness of a web-based cognitive training program to improve working memory in a sample of 58 persons with HIV and cocaine use disorder. Participants were randomly assigned to either the experimental working memory training arm or the attention control training arm and completed up to 48 daily sessions over 10weeks. Overall, treatment completion (74%) and retention rates (97%) were high, and participant feedback indicated the intervention was acceptable. Our results show that the intervention successfully reduced working memory deficits in the experimental arm relative to the control arm. Our findings support both the feasibility and effectiveness of cognitive training in this population.

Upper Arm Action Recognition for Self Training with a Smartphone

The action recognition for upper arm training, in low-cost and effective way, has great application in both sport training and rehabilitation training. However,they almost require extra and expensive equipments. This paper proposes an approach for real-time recognition of upper arm actions based on Hidden Markov Model (HMM) only one sensor and one smartphoneare needed. Data collected by a sensor and Action Pattern Sets are established with HMM training. Empirical Results with the smartphone, one for self-coaching for badminton technique improvement and another for arm injuries rehabilitation, validating the effectiveness and usability. Some problems found on site show that the next step is to further optimize the Action Pattern Sets to improve the overall accuracy and users’subjective satisfaction.

Assessing True Variability And Mean Changes To Two Distinct Resistance Training Protocols

Millions of dollars are spent analyzing inter-individual differences in response to resistance exercise, but the lack of a non-exercise control group makes it possible that these studies may simply be examining random error. Furthermore, it has been hypothesized that the magnitude of variability may differ depending upon the exercise protocol employed, but this yet to be appropriately tested. PURPOSE: To determine differences in two distinct resistance training protocols and whether true variability could be detected after accounting for random error. METHODS: Individuals (n=151) were randomly assigned to one of three groups: (1) a traditional exercise group performing four sets of elbow flexion exercise to failure; (2) a one-repetition maximum (1RM) performing a 1RM elbow flexion test; and (3) a time-matched non-exercise control group. Both exercise groups performed 18 sessions over six weeks. A Bayesian ANCOVA was used to test for mean changes across groups while adjusting for pre-values. To assess whether the variability in response to each exercise intervention differed from that of the control group, Bayesian Levene’s tests were computed. Bayes Factors (BF10) were used to quantify evidence for or against the null hypothesis. RESULTS: Both 1RM (2.3kg; BF10 = 4.791e+6) and traditional training groups (2.4kg; BF10 = 11,915) increased 1RM strength similarly (BF10 = 0.21), but only the 1RM group increased untrained arm 1RM strength (1.5kg; BF10 = 271). Only the traditional exercise group increased ultrasound measured muscle thickness (~0.23 cm across all sites; all BF10 ≥ 224). Across both training groups, the only differential responses were found in the change in 1RM strength of the trained arm in the traditional training group (BF10 = 5.381). This resulted in a true variability of 1.8 kg after the removal of random error. CONCLUSION: These findings demonstrate the importance of taking into consideration the magnitude of random error when determining response heterogeneity, as many studies may be classifying individuals based on random error. Additionally, our mean results demonstrate that strength is largely driven by task specificity, and the cross-over effect of strength may be load dependent.