Understanding the complex and dynamic nature of experiences requires the use of proper measurement tools. As interest grows in the objective measurement of experiences within tourism and hospitality, there is an urgent need to consolidate and synthesize these studies. Thus, this study investigated prevalent objective measurement techniques via a systematic review. We analyzed physiological measures such as electroencephalography (EEG), heart rate variability (HRV), skin conductance (SC), and facial electromyography (fEMG) along with behavioral measures, including eye tracking and location tracking. This review identified 100 empirical studies that employed objective measurement to examine tourism and hospitality experiences over the last decade, highlighting trends, research contexts and designs, and the synergies between different methods. Our discussion on methodological issues and best practices will help researchers and practitioners identify the best tools to capture people’s experiences and promote more standardized practices and comparable findings on studying experiences in tourism and hospitality settings.
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Objective: To systematically review and critically appraise the literature on measurement properties of cardiopulmonary exercise test protocols for measuring aerobic capacity, VO2max, in persons after stroke. Data sources: PubMed, Embase and Cinahl were searched from inception up to 15 June 2016. A total of 9 studies were identified reporting on 9 different cardiopulmonary exercise test protocols. Study selection: VO2max measured with cardiopulmonary exercise test and open spirometry was the construct of interest. The target population was adult persons after stroke. We included all studies that evaluated reliability, measurement error, criterion validity, content validity, hypothesis testing and/ or responsiveness of cardiopulmonary exercise test protocols. Data extraction: Two researchers independently screened the literature, assessed methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments checklist and extracted data on measurement properties of cardiopulmonary exercise test protocols. Data synthesis: Most studies reported on only one measurement property. Best-evidence synthesis was derived taking into account the methodological quality of the studies, the results and the consistency of the results. Conclusion: No judgement could be made on which protocol is “best” for measuring VO2max in persons after stroke due to lack of high-quality studies on the measurement properties of the cardiopulmonary exercise test.
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The use of measurement instruments has become a major issue in physical therapy, but their use in daily practice is infrequent. The aims of this case report were to develop and evaluate a plan for the systematic implementation of two measurement instruments frequently recommended in Dutch physical therapy clinical guidelines: the Patient-Specific Complaints instrument and the Six-Minute Walk Test.
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Objective In voice assessment, the evaluation of voice quality is a major component in which roughness has received wide acceptance as a major subtype of abnormal voice quality. The aim of the present study was to develop a new multivariate acoustic model for the evaluation of roughness. Method In total, 970 participants with dysphonia and 88 participants with normal voice were included. Concatenated voice samples of continuous speech and sustained vowel [a:] were perceptually judged on roughness severity. Acoustic analyses were conducted on the voiced segments of the continuous speech sample plus sustained vowel as well. A stepwise multiple linear regression analysis was applied to construct an acoustic model of the best acoustic predictors. Concurrent validity, diagnostic accuracy, and cross-validation were verified on the basis of Spearman correlation coefficient (rs), several estimates of the receiver operating characteristics plus the likelihood ratio, and iterated internal cross-correlations. Results Six experts were included for perceptual analysis based on acceptable rater reliability. Stepwise multiple regression analysis yielded a 12-variable acoustic model. A marked correlation was identified between the model and the perceptual judgment (rs = 0.731, P = 0.000). The cross-correlations confirmed a high comparable degree of association. However, the receiver operating characteristics and likelihood ratio results showed the best diagnostic outcome at a threshold of 2.92, with a sensitivity of 51.9% and a specificity of 94.9%. Conclusions Currently, the newly developed roughness model is not recommended for clinical practice. Further research is needed to detect the acoustic complexity of roughness (eg, multiplophonia, irregularity, chaotic structure, glottal fry, etc).
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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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Objective: To determine the construct validity, criterion validity, and responsiveness of measurement instruments evaluating scapular function. Design: Systematic review of measurement properties. Literature Search: The MEDLINE, Embase, CINAHL, and SPORTDiscus databases were systematically searched from inception until March 2019. Study Selection Criteria: Studies published in Dutch, English, or German were included when they evaluated at least 1 of the measurement properties of interest. No restrictions were made regarding participants' health status. Data Synthesis: Two reviewers independently evaluated study quality using the COSMIN checklist and extracted and analyzed data. Quality of evidence was graded by measurement property for each distinctive type of measurement. Results: Thirty-one measurement instruments in 14 studies were categorized into instruments to measure scapular posture and movement, and to assess scapular dyskinesis. Quality of evidence was at most moderate for 4 instruments with respect to criterion validity. Of these, criterion validity for instruments measuring scapular protraction/retraction posture and rotation angles up to 120° of thoracohumeral elevation was sufficient. Criterion validity for instruments measuring asymmetrical scapular posture, range of motion, and the lateral scapular slide test was insufficient. Quality of evidence for measurement properties of all other instruments was graded lower. Conclusion: There is currently insufficient evidence to recommend any instrument for the clinical examination of scapular function. Measurement instruments to assess scapular dyskinesis are prone to misinterpretation and should therefore not be used as such.
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Background Objective gait analysis that fully captures the multi-segmental foot movement of a clubfoot may help in early identification of a relapse clubfoot. Unfortunately, this type of objective measure is still lacking in a clinical setting and it is unknown how it relates to clinical assessment. Research question The aim of this study was to identify differences in total gait and foot deviations between clubfoot patients with and without a relapse clubfoot and to evaluate their relationship with clinical status. Methods In this study, Ponseti-treated idiopathic clubfoot patients were included and divided into clubfoot patients with and without a relapse. Objective gait analysis was done resulting in total gait and foot scores and clinical assessment was performed using the Clubfoot Assessment Protocol (CAP). Additionally, a new clubfoot specific foot score, the clubFoot Deviation Index (cFDI*), was calculated to better capture foot kinematics of clubfoot patients. Results Clubfoot patients with a relapse show lower total gait quality (GDI*) and lower clinical status defined by the CAP than clubfoot patients without a relapse. Abnormal cFDI* was found in relapse patients, reflected by differences in corresponding variable scores. Moderate relationships were found for the subdomains of the CAP and total gait and foot quality in all clubfoot patients. Significance A new total foot score was introduced in this study, which was more relevant for the clubfoot population. The use of this new foot score (cFDI*) besides the GDI*, is recommended to identify gait and foot motion deviations. Along with clinical assessment, this will give an overview of the overall status of the complex, multi-segmental aspects of a (relapsed) clubfoot. The relationships found in this study suggest that clinical assessment might be indicative of a deviation in total gait and foot pattern, therefore hinting towards personalised screening for better treatment decision making.
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Quantifying measures of physical loading has been an essential part of performance monitoring within elite able-bodied sport, facilitated through advancing innovative technology. In wheelchair court sports (WCS) the inter-individual variability of physical impairments in the athletes increases the necessity for accurate load and performance measurements, while at the same time standard load monitoring methods (e.g. heart-rate) often fail in this group and dedicated WCS performance measurement methods are scarce. The objective of this review was to provide practitioners and researchers with an overview and recommendations to underpin the selection of suitable technologies for a variety of load and performance monitoring purposes specific to WCS. This review explored the different technologies that have been used for load and performance monitoring in WCS. During structured field testing, magnetic switch based devices, optical encoders and laser systems have all been used to monitor linear aspects of performance. However, movement in WCS is multidirectional, hence accelerations, decelerations and rotational performance and their impact on physiological responses and determination of skill level, is also of interest. Subsequently both for structured field testing as well as match-play and training, inertial measurement units mounted on wheels and frame have emerged as an accurate and practical option for quantifying linear and non-linear movements. In conclusion, each method has its place in load and performance measurement, yet inertial sensors seem most versatile and accurate. However, to add context to load and performance metrics, position-based acquisition devices such as automated image-based processing or local positioning systems are required.
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An important performance determinant in wheelchair sports is the power exchanged between the athletewheelchair combination and the environment, in short, mechanical power. Inertial measurement units (IMUs) might be used to estimate the exchanged mechanical power during wheelchair sports practice. However, to validly apply IMUs for mechanical power assessment in wheelchair sports, a well-founded and unambiguous theoretical framework is required that follows the dynamics of manual wheelchair propulsion. Therefore, this research has two goals. First, to present a theoretical framework that supports the use of IMUs to estimate power output via power balance equations. Second, to demonstrate the use of the IMU-based power estimates during wheelchair propulsion based on experimental data. Mechanical power during straight-line wheelchair propulsion on a treadmill was estimated using a wheel mounted IMU and was subsequently compared to optical motion capture data serving as a reference. IMU-based power was calculated from rolling resistance (estimated from drag tests) and change in kinetic energy (estimated using wheelchair velocity and wheelchair acceleration). The results reveal no significant difference between reference power values and the proposed IMU-based power (1.8% mean difference, N.S.). As the estimated rolling resistance shows a 0.9–1.7% underestimation, over time, IMU-based power will be slightly underestimated as well. To conclude, the theoretical framework and the resulting IMU model seems to provide acceptable estimates of mechanical power during straight-line wheelchair propulsion in wheelchair (sports) practice, and it is an important first step towards feasible power estimations in all wheelchair sports situations.
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Background: To experience external objects in such a way that they are perceived as an integral part of one's own body is called embodiment. Wearable technology is a category of objects, which, due to its intrinsic properties (eg, close to the body, inviting frequent interaction, and access to personal information), is likely to be embodied. This phenomenon, which is referred to in this paper as wearable technology embodiment, has led to extensive conceptual considerations in various research fields. These considerations and further possibilities with regard to quantifying wearable technology embodiment are of particular value to the mobile health (mHealth) field. For example, the ability to predict the effectiveness of mHealth interventions and knowing the extent to which people embody the technology might be crucial for improving mHealth adherence. To facilitate examining wearable technology embodiment, we developed a measurement scale for this construct. Objective: This study aimed to conceptualize wearable technology embodiment, create an instrument to measure it, and test the predictive validity of the scale using well-known constructs related to technology adoption. The introduced instrument has 3 dimensions and includes 9 measurement items. The items are distributed evenly between the 3 dimensions, which include body extension, cognitive extension, and self-extension.Methods: Data were collected through a vignette-based survey (n=182). Each respondent was given 3 different vignettes, describing a hypothetical situation using a different type of wearable technology (a smart phone, a smart wristband, or a smart watch) with the purpose of tracking daily activities. Scale dimensions and item reliability were tested for their validity and Goodness of Fit Index (GFI). Results: Convergent validity of the 3 dimensions and their reliability were established as confirmatory factor analysis factor loadings45 (>0.70), average variance extracted values40 (>0.50), and minimum item to total correlations50 (>0.40) exceeded established threshold values. The reliability of the dimensions was also confirmed as Cronbach alpha and composite reliability exceeded 0.70. GFI testing confirmed that the 3 dimensions function as intercorrelated first-order factors. Predictive validity testing showed that these dimensions significantly add to multiple constructs associated with predicting the adoption of new technologies (ie, trust, perceived usefulness, involvement, attitude, and continuous intention). Conclusions: The wearable technology embodiment measurement instrument has shown promise as a tool to measure the extension of an individual's body, cognition, and self, as well as predict certain aspects of technology adoption. This 3-dimensional instrument can be applied to mixed method research and used by wearable technology developers to improve future versions through such things as fit, improved accuracy of biofeedback data, and customizable features or fashion to connect to the users' personal identity. Further research is recommended to apply this measurement instrument to multiple scenarios and technologies, and more diverse user groups.
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