Objective: This exploratory study investigated to what extent gait characteristics and clinical physical therapy assessments predict falls in chronic stroke survivors. Design: Prospective study. Subjects: Chronic fall-prone and non-fall-prone stroke survivors. Methods: Steady-state gait characteristics were collected from 40 participants while walking on a treadmill with motion capture of spatio-temporal, variability, and stability measures. An accelerometer was used to collect daily-life gait characteristics during 7 days. Six physical and psychological assessments were administered. Fall events were determined using a “fall calendar” and monthly phone calls over a 6-month period. After data reduction through principal component analysis, the predictive capacity of each method was determined by logistic regression. Results: Thirty-eight percent of the participants were classified as fallers. Laboratory-based and daily-life gait characteristics predicted falls acceptably well, with an area under the curve of, 0.73 and 0.72, respectively, while fall predictions from clinical assessments were limited (0.64). Conclusion: Independent of the type of gait assessment, qualitative gait characteristics are better fall predictors than clinical assessments. Clinicians should therefore consider gait analyses as an alternative for identifying fall-prone stroke survivors.
This article presents and discusses student assignments reflecting on the documentary film If a Tree Falls, written as part of the Business Ethics and Sustainability course at The Hague University of Applied Sciences. This article follows two lines of inquiry. First, it challenges mainstream environmental education, supporting critical pedagogy and ecopedagogy. These pedagogies, which advocate pedagogy for radical change, offer a distinct and valuable contribution to sustainability education, enabling students to critically examine normative assumptions, and learn about ethical relativity, and citizenship engagement from environmentalists. The discussion of “lessons of radical environmentalism” is pertinent to the question of what types of actions are likely to achieve the widely acceptable long-term societal change. While this article focuses on student reflection on a film about radical environmentalism, this article also discusses many forms of activism and raises the question of what can be considered effective activism and active citizenship in the context of the philosophy of (environmental or sustainability) education in connection didactics and curriculum studies. Second, this article argues for the need for reformed democracy and inclusive pluralism that recognizes the needs of nonhuman species, ecocentrism, and deep ecology. The connection between these two purposes is expressed in the design of the student assignment: It is described as a case study, which employs critical pedagogy and ecopedagogy. https://doi.org/10.3390/educsci9040284 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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Abstract Introduction Stroke survivors often fall during walking. To reduce fall risk, gait testing and training with avoidance of virtual obstacles is gaining popularity. However, it is unknown whether and how virtual obstacle crossing is associated with fall risk. Aim The present study assessed whether obstacle crossing characteristics are reliable and assessed differences in stroke survivors who prospectively experienced falls or no falls. Method We recruited twenty-nine community dwelling chronic stroke survivors. Participants crossed five virtual obstacles with increasing lengths. After a break, the test was repeated to assess test-retest reliability. For each obstacle length and trial, we determined; success rate, leading limb preference, pre and post obstacle distance, margins of stability, toe clearance, and crossing step length and speed. Subsequently, fall incidence was monitored using a fall calendar and monthly phone calls over a six-month period. Results Test-retest reliability was poor, but improved with increasing obstacle-length. Twelve participants reported at least one fall. No association of fall incidence with any of the obstacle crossing characteristics was found. Discussion Given the absence of height of the virtual obstacles, obstacle avoidance may have been relatively easy, allowing participants to cross obstacles in multiple ways, increasing variability of crossing characteristics and reducing the association with fall risk. Conclusion These finding cast some doubt on current protocols for testing and training of obstacle avoidance in stroke rehabilitation.
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Horse riding falls under the “Sport for Life” disciplines, where a long-term equestrian development can provide a clear pathway of developmental stages to help individuals, inclusive of those with a disability, to pursue their goals in sport and physical activity, providing long-term health benefits. However, the biomechanical interaction between horse and (disabled) rider is not wholly understood, leaving challenges and opportunities for the horse riding sport. Therefore, the purpose of this KIEM project is to start an interdisciplinary collaboration between parties interested in integrating existing knowledge on horse and (disabled) rider interaction with any novel insights to be gained from analysing recently collected sensor data using the EquiMoves™ system. EquiMoves is based on the state-of-the-art inertial- and orientational-sensor system ProMove-mini from Inertia Technology B.V., a partner in this proposal. On the basis of analysing previously collected data, machine learning algorithms will be selected for implementation in existing or modified EquiMoves sensor hardware and software solutions. Target applications and follow-ups include: - Improving horse and (disabled) rider interaction for riders of all skill levels; - Objective evidence-based classification system for competitive grading of disabled riders in Para Dressage events; - Identifying biomechanical irregularities for detecting and/or preventing injuries of horses. Topic-wise, the project is connected to “Smart Technologies and Materials”, “High Tech Systems & Materials” and “Digital key technologies”. The core consortium of Saxion University of Applied Sciences, Rosmark Consultancy and Inertia Technology will receive feedback to project progress and outcomes from a panel of international experts (Utrecht University, Sport Horse Health Plan, University of Central Lancashire, Swedish University of Agricultural Sciences), combining a strong mix of expertise on horse and rider biomechanics, veterinary medicine, sensor hardware, data analysis and AI/machine learning algorithm development and implementation, all together presenting a solid collaborative base for derived RAAK-mkb, -publiek and/or -PRO follow-up projects.
Bicycle manufacturing currently falls behind the fast technological developments in automotive industries. We propose to design, develop and test a smart cycling eco-system where bicycles communicate in realtime with each other, and with the urban transport infrastructure (e.g. traffic lights) to optimize the use and improve traffic safety, economical value, and efficiency. This require technologies and mechanisms to allow monitoring the bike, understanding the cyclist and the context, as well as data sharing between cyclists, industry, service providers, government, and urban planners. The new eco-system can drive decision-making, behaviour incentivisation, and ultimately investment, across government, and beyond. A key ingredient is an AI-enabled IoT ecosystem in which data is securely collected, shared, processed in combination with other data sources, and made available to establish new services. This allows to reliably identify relevant events (like dangerous situations), detect trends (like decreasing performance of components, allowing maintenance to be performed in time), and give new insights to the user (such as health and performance).
