No description available.

Several outcome tools have been developed to measure physical functioning in pediatric orthopedic patients. One such tool, the Activities Scale for Kids (ASK), allows assessment of physical functioning in the community in 5-to 15-year-olds. Previous validation of the ASK showed a significant difference in scores according to global ratings of disability. In this study, the ASK was administered to children without musculoskeletal disability to determine how normal respondents scored. ASK questionnaires were distributed to 137 children and 122 (89%) were returned. Normal children scored quite high, with a mean summary score of 93.12 (SD 6.45). This score differs significantly from the mean summary score for children with mild disabilities as determined in previous studies of disability (P = 0.005). / Study conducted at the Children’s Hospital of Eastern Ontario, Universityof Ottawa, Ottawa, Ontario, Canada. / Dr. Plint is supported in part by a Junior Clinical Investigator Award from the Children’s Hospital of Eastern Ontario Research Institute.

As awareness of the costs of workplace injury and illness continues to grow, there has been an increased demand for effective ergonomic interventions to reduce the prevalence of musculoskeletal disorders (MSDs). The goal of ergonomic interventions is to reduce exposures (mechanical and psychosocial); however there is conflicting evidence about the impact of these interventions as many studies produce inconclusive or conflicting results. In order to provide a clearer picture of the effectiveness of these interventions, we must find out if methodological issues, particularly statistical power, are limiting this research. The purpose of this study was to review and examine factors influencing statistical power in ergonomic intervention papers from five peer reviewed journals in 2008. A standardized review was performed by two reviewers. Twenty eight ergonomic intervention papers met the inclusion criteria and were fully reviewed. Data and trends from the reviewed papers were summarized specifically looking at the research designs used, the outcome measures used, if statistical power was mentioned, if a rationale for sample size was reported, if standardized and un-standardized effect sizes were reported, if confidence intervals were reported, the alpha levels used, if pair-wise correlation values were provided, if mean values and standard deviations were provided for all measures and the location of the studies. Also, the studies were rated based on the outcomes of their intervention into one of three categories (shown to be effective, inconclusive and not shown to be effective). Between these three groupings comparisons of post hoc power, standardized effect sizes, un-standardized effect sizes and coefficients of variation were made. The results indicate that in general, a lack of statistical power is indeed a concern and may be due to the sample sizes used, effect sizes produced, extremely high variability in some of the measures, the lack of attention paid to statistical power during research design and the lack of appropriate statistical reporting guidelines in journals where ergonomic intervention research may be published. A total of 69.6% of studies reviewed had a majority of measures with less than .50 power and 71.4% of all measures used had CVs of > .20.

As awareness of the costs of workplace injury and illness continues to grow, there has been an increased demand for effective ergonomic interventions to reduce the prevalence of musculoskeletal disorders (MSDs). The goal of ergonomic interventions is to reduce exposures (mechanical and psychosocial); however there is conflicting evidence about the impact of these interventions as many studies produce inconclusive or conflicting results. In order to provide a clearer picture of the effectiveness of these interventions, we must find out if methodological issues, particularly statistical power, are limiting this research. The purpose of this study was to review and examine factors influencing statistical power in ergonomic intervention papers from five peer reviewed journals in 2008. A standardized review was performed by two reviewers. Twenty eight ergonomic intervention papers met the inclusion criteria and were fully reviewed. Data and trends from the reviewed papers were summarized specifically looking at the research designs used, the outcome measures used, if statistical power was mentioned, if a rationale for sample size was reported, if standardized and un-standardized effect sizes were reported, if confidence intervals were reported, the alpha levels used, if pair-wise correlation values were provided, if mean values and standard deviations were provided for all measures and the location of the studies. Also, the studies were rated based on the outcomes of their intervention into one of three categories (shown to be effective, inconclusive and not shown to be effective). Between these three groupings comparisons of post hoc power, standardized effect sizes, un-standardized effect sizes and coefficients of variation were made. The results indicate that in general, a lack of statistical power is indeed a concern and may be due to the sample sizes used, effect sizes produced, extremely high variability in some of the measures, the lack of attention paid to statistical power during research design and the lack of appropriate statistical reporting guidelines in journals where ergonomic intervention research may be published. A total of 69.6% of studies reviewed had a majority of measures with less than .50 power and 71.4% of all measures used had CVs of > .20.

Background: Care transitions are a common and frequently adverse aspect of health care, resulting in a high-risk period for both care quality and patient safety (Coleman, 2003; Forster et al., 2003; Picker Institute 1999; van Walraven et al., 2004; Cook et al., 2000). Patients who have complex care needs and undergo treatment from multiple care settings may be at a greater risk for poor care transitions (Coleman et al., 2004). Using quantitative performance measurement scales is one method that can assess the quality of care transitions, and identify areas for improvement. The psychometric properties of the primary performance measurement scale, the Care Transitions Measure (CTM), have not been rigorously assessed, particularly within a higher risk, medically complex population such as older adults with musculoskeletal (MSK) disorders. Furthermore, despite the negative health implications that can result from poor transitions and the commonality of care transitions among persons with complex care needs, there is a significant dearth of research on this crucial aspect of health care. Methods: This research examines the ability of the CTM to adequately assess the quality of care transitions among a complex population of older MSK rehabilitation patients and explores care transitions from the perspective of the patient and the health care provider. Information was gathered through telephone administration of the CTM to MSK patients after they transitioned from inpatient rehabilitation units to home, and through a series of qualitative key informant interviews with a range of health care professionals in care settings relevant to the care continuum of older MSK patients. Inter-rater reliability, a type of reliability that has never been tested with the CTM, and construct validity were assessed and qualitative analyses were used to examine qualitative information obtained through the CTM administration to patients and through the interviews with health care providers. Results: The CTM demonstrated excellent inter-rater reliability for the overall score (intraclass correlation coefficient = 0.77; p=0.03) despite only fair agreement between each item. Internal consistency of the CTM was high (Cronbach’s alpha = 0.94). The construct validity of the CTM was supported; however qualitative data from the patient and health care provider perspectives suggest additional items should be considered for inclusion. Qualitative information from patients also suggests the need for revisions to the wording of some items and the response options. Health care provider interviews suggest that issues surrounding transitional care are similar regardless of the care setting involved. Conclusions: Although the CTM proved to be reliable, qualitative data suggests that the addition of items should be considered to improve the content validity of the CTM, which would in turn improve its construct validity as well. Recommendations for scale improvement are made, as are recommendations for an alternative scale to assess care transition quality from a health care provider perspective. The results of this study support efforts to improve the outcomes of care transitions, care planning, and the overall quality of life for older rehabilitation patients.

The purpose of this study was to describe perceived psychosocial work environment and musculoskeletal complaints among baggage handlers, and to evaluate whether there is any linear relationship between them. The study is a questionnaire based cross-sectional study, and part of an ongoing larger project. Therefore, the number of forms has been limited to those that were collected in the project by 2010-11-25 (N=117). The questions analyzed in the study come from the Copenhagen Psychosocial Questionnaire and “Nordiska Ministerrådets formulär om besvär i rörelseorganen”, respectively. In addition, ratings of pain intensity according to Borg CR-scale have been used. Linear correlations were assessed by Spearman’s rank correlation. The results showed that the baggage handlers rated good sense of Community and low Emotional demands, but poor Influence and Feedback at the workplace. Their ratings of pain frequency and intensity were relatively low, but the regions where they had most complaints were shoulders and low back. The highest correlation was -0.36 between Meaning and pain frequency in the Shoulders. No particular psychosocial factor or body region appeared highly correlated with all or most of the other variables. For the psychosocial environment factors investigated in this study no extremely good or extremely bad values were discovered. Musculoskeletal complaints were low. No strong correlations between baggage handlers ratings of psychosocial work environment and musculoskeletal complaints were found in this study.

To understand control strategies employed by the central nervous system (CNS) control movement or force generation in a limb, a seven degree of freedom cat hindlimb was modeled. In this study, the biomechanical constraints affecting force generation for balance and postural control were investigated. Due to the redundancies at the muscular and joint levels in the musculoskeletal system, even the muscle coordination pattern to statically produce a certain amount of force/torque at the ground is not straightforward. A 3D musculoskeletal model of the cat hindlimb was created from cat cadaver measurements using Software for Interactive Musculoskeletal Systems (SIMM, Musculographics, Inc.). Six kinematic degrees of freedom and 31 individual hindlimb muscles were modeled. The moment arms of the muscles were extracted from the software model to be used in a linear transformation between muscle activation, and end effector force and moment. The Jacobian matrix that establishes the relationship between joint torques and end effector wrench was calculated. Maximal muscle forces were estimated from the literature. A feasible set of forces that can be generated at the toe was constructed using combination of maximally activated muscle excitations. Because the endpoint torque is typically small in a cat, an optimization algorithm was also performed to maximize the force generation at the end effector while constraining the magnitude of the endpoint torque. The results are compared with the measured force magnitude and direction data from an acute cat hindlimb preparation for different postures. This static model is applicable for understanding muscle coordination during postural responses to small balance perturbations.

No description available.

Thesis (Ph.D.)--East Carolina University, 2009. / Presented to the faculty of the Department of Exercise and Sports Science. Advisor: Joseph A. Houmard. Title from PDF t.p. (viewed Apr. 30, 2010). Includes bibliographical references.

Thesis (M.S.)--East Carolina University, 2009. / Presented to the faculty of the Department of Exercise and Sport Science. Advisor: Paul DeVita. Title from PDF t.p. (viewed May 4, 2010). Includes bibliographical references.