INTRODUCTION: The interpolated twitch technique is often used to assess voluntary activation (VA) of skeletal muscles. We investigated VA and the voluntary torque-superimposed torque relationship using either supramaximal nerve stimulation or better tolerated submaximal muscle stimulation, which is often used with patients. METHODS: Thirteen healthy subjects performed maximal and submaximal isometric knee extensions with superimposed maximal or submaximal doublets (100 Hz). RESULTS: Superimposed torque relative to potentiated resting doublets was smaller with maximal nerve than with submaximal muscle stimulation. Maximal VA was 87 ± 7% and 93 ± 5% for submaximal muscle and maximal nerve stimulation, respectively. The individual voluntary torque-superimposed torque relationships were more linear for submaximal muscle stimulation, possibly leading to less overestimation of VA. CONCLUSIONS: Submaximal muscle stimulation can be used to estimate VA in the knee extensors. It is less painful, and overestimation of VA may be less compared with maximal nerve stimulation.
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The purpose of this study was to determine the impact of vagal nerve stimulation (VNS) on the vocal quality using the dysphonia severity index (DSI). It was hypothesized that the objective vocal quality and other vocal characteristics are disordered in comparison with an age- and gender-matched control group. In addition, the acoustic vocal parameters were compared during three conditions: at rest, during normal stimulation, and raised stimulation. A significant relation between the amount of stimulation and the presence of disturbed acoustic parameters was hypothesized.Subjective (auditory-perceptual evaluation and voice handicap index) and objective (aerodynamic, vocal range, acoustic measurements and determination of the DSI) measurements were used to determine the vocal quality in 13 subjects with VNS in three different conditions (at rest and during normal and raised stimulation) and the age- and gender-matched control group.The subjects with VNS had a disordered perceptual vocal quality mainly characterized by the presence of a moderate roughness and slight breathiness, and the objective vocal quality by means of the DSI value is -2.4. During stimulation and especially during raised stimulation, the fundamental frequency is significantly increased. However, the subjects experienced no psychosocial handicapping effect of the vocal quality on the quality of life.Subjects with VNS have typical vocal characteristics. Ear, nose, and throat specialists and voice therapist must be aware of the presence of this vocal pattern at rest and during normal and raised stimulation. Especially, professional voice users and elite vocal performers must be informed before implantation.
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The medical back belt with integrated neuromuscular electrical stimulation is anorthopedic device, which has two main functions. The first function is to stimulate the backmuscles by using a neuromuscular electrical stimulation device that releases regular,electrical impulses. The second function of the medical back belt is the stabilization of theback after lumbar disk herniation’s so that a straight posture can be realized.The product has the opportunity to give lumbar back support and encourage the back musclesto prevent muscle weakness. The integrated neuromuscular electrical stimulation in the beltconsists out of two main components: The NMES device and the textile electrodes. Byactivating the NMES device it transmits electrical impulse to the textile electrodes, which canprickle the muscles.In the future, this product possibly can make a straight posture of the back andsimultaneously stimulation of the back muscles possible. Paper for the 14th Autex World Textile Conference, May 26th-28th, Bursa, Turkey.
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Student satisfaction gains an increasingly central position in the context of quality measurements. However, student satisfaction can also be stipulated as an important motivational factor for students as learners. This study combines this perspective on student satisfaction with the notion of differences in students’ ability. We hypothesize that differences in ability result in differences in student satisfaction. In line with concepts of high ability education, it is additionally hypothesized that this relation is mediated by educational stimulation - divided in cognitive, creative and professional stimulation – as well as by participation in honours programs. A structural equation modelling (N=733) of factors affecting student satisfaction in higher education shows that cognitive, creative and professional stimulation are the largest influencers of bachelor students’ sense of satisfaction. The interrelation between these three aspects of educational stimulation also shows the complexity of higher educational practice, since it suggests that cognitive stimulation cannot be realized without a creative factor, and vice versa. Professional stimulation needs both. Furthermore, the results show that educational stimulation mediates the effect of students’ ability on their educational satisfaction. This implies that changes in education can indeed influence students’ educational satisfaction, especially by providing educational quality. Finally, considering students’ ability level, it is shown that especially cognitive abler students are less easy to satisfy. The combination of educational stimulation and ability suggests that especially the more cognitive able students do not feel themselves sufficiently cognitively or creatively stimulated, and hence are less satisfied in vocational higher education.
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OBJECTIVE: To evaluate if using surface neuromuscular electrical stimulation (NMES) for paralyzed lower-limb muscles results in an increase in energy expenditure and if the number of activated muscles and duty cycle affect the potential increase.DESIGN: Cross-sectional study.RESULTS: Energy expenditure during all NMES protocols was significantly higher than the condition without NMES (1.2 ± 0.2 kcal/min), with the highest increase (+ 51%; +0.7 kcal/min, 95% CI: 0.3 - 1.2) for the protocol with more muscles activated and the duty cycle with a shorter rest period. A significant decrease in muscle contraction size during NMES was found with a longer stimulation time, more muscles activated or the duty cycle with a shorter rest period.CONCLUSION: Using NMES for paralyzed lower-limb muscles can significantly increase the energy expenditure compared to sitting without NMES with the highest increase for the protocol with more muscles activated and the duty cycle with a shorter rest period. Muscle fatigue occurred significantly with the more intense NMES protocols which might cause a lower energy expenditure in a longer protocol. Future studies should further optimize the NMES parameters and investigate the long-term effects of NMES on weight management in people with SCI.
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PURPOSE: The current article provides a description of the construction process of a short questionnaire that measures patients' experiences with a motivational interviewing consultation by a (sports) counselor in rehabilitation. Subsequently, results from confirmatory factor analyses are presented to investigate a first perspective on factorial construct validity of the questionnaire.MATERIAL AND METHODS: Based on motivational interviewing literature, an initial item pool was created. All items were critically reviewed, resulting in the new "Evaluation of Motivational Interviewing Consultation on Active Lifestyle and Sports" questionnaire. The final items were determined by a confirmatory factor analysis based on 890 completed questionnaires.RESULTS: The initial 26-item questionnaire consisted of four inter-correlated subscales. Factor analyses underpinned the proposed factors: acceptance, evocation, partnership, and non-adherent. After removing six items, an alternative model remained and showed an acceptable model fit. The internal consistency of the subscales derived varied from 0.70 to 0.90.CONCLUSION: The shortened questionnaire provides a feasible and easy to administer tool and may provide a cost saving method of assessing motivational interviewing fidelity from a patient's perspective in disability and rehabilitation. Implications for rehabilitation Many persons with a physical disability do not obtain the recommended amount of physical activity in order to maintain health. Stimulation of a physically active lifestyle through motivational interviewing is promising. Measuring motivational interviewing treatment fidelity is time consuming and often from a counselor's perspective. We developed a short questionnaire facilitating the assessment of treatment fidelity at the side of the client. Our questionnaire provides a feasible and easy to administer tool for assessing MI fidelity in daily rehabilitation practice.
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Purpose: Applying evidence-based grammar intervention can be challenging for speech and language therapists (SLTs). Language in Interaction Therapy (LIT) is a focused stimulation intervention for children with weak morphosyntactic skills, which was developed to support SLTs in incorporating results from effect studies in daily practice. The aims of this Clinical Focus are (a) to explain the principles and elements of LIT and stimulate use in daily SLT practice and (b) to describe the effects of LIT on morphosyntactic skills of 4- to 5-year-olds in special education, compared to usual care. Method: With a description of LIT, we provide guidance to implement evidence-based intervention. Important elements are as follows: proper selection of therapy goals, language facilitating techniques, child-centered and clinician-directed elements, and the use of scripts. Our focus in the description is on the support and practical solutions LIT tries to provide to SLTs. We also explored the implementation of LIT in special education, to improve morphosyntax in 4- and 5-year-old children. We provided SLTs with training and designed protocols for each therapy session. The effects of LIT were measured in a single-case A-B design, repeated in five children with developmental language disorders (ages 4;2-5;7 [years;months]). Conclusion: We conclude that implementation of LIT is possible if LIT is enriched with support in goal selection, protocols to guide therapy sessions, and training and coaching. In the single-case study, four children showed more growth in mean length of utterance during and directly following the LIT intervention phase, compared to the baseline phase with usual care, and in two of them, this difference was significant. The grammatical complexity measure "TARSP-P" showed an overall significantly higher score at group level during LIT, but limited effects on an individual level.
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Abstract—Pressure ulcers (PUs) are highly prevalent in people with spinal cord injury (SCI). Electrical stimulation (ES) activates muscles and might reduce risk factors. Our objectives were to study and compare the effects of two duty cycles during 3 h of ES-induced gluteal and hamstring activation on interface pressure distribution in sitting individuals with SCI and study the usability of a newly developed electrode garment (ES shorts). Ten individuals with SCI participated in this study, in which two ES protocols with different duty cycles (1:1 s vs 1:4 s on-off) were applied in counterbalanced order using a custom-made garment with built-in electrodes. Outcome variables included interface pressure of the ischial tuberosities (ITs) and pressure gradient. A questionnaire was used to determine usability of the ES shorts. In both protocols, ES caused a significant decrease in average IT pressure compared with rest (no ES); on average, 35% for protocol 1:4 and 13% for protocol 1:1. The ES on-off duty cycle of protocol 1:4 showed less muscle fatigue. In general, participants scored the usability of the ES shorts as satisfactory. In this study, the application of ES resulted in a significant decrease in IT pressure. The ES on-off duty cycle of 1:4 s is recommended because of the less fatiguing effect. ES of the hamstrings and gluteal muscles might be a promising method in preventing PUs, but further study is needed.
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In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance.
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