Local experience of laboratory activities in a BS physical therapy course: integrating sEMG and kinematics technology with active learning across six cohorts

Introduction

Integrating technology and active learning methods into Laboratory activities would be a transformative educational experience to familiarize physical therapy (PT) students with STEM backgrounds and STEM-based new technologies. However, PT students struggle with technology and feel comfortable memorizing under expositive lectures. Thus, we described the difficulties, uncertainties, and advances observed by faculties on students and the perceptions about learning, satisfaction, and grades of students after implementing laboratory activities in a PT undergraduate course, which integrated surface-electromyography (sEMG) and kinematic technology combined with active learning methods.

Methods

Six cohorts of PT students (n = 482) of a second-year PT course were included. The course had expositive lectures and seven laboratory activities. Students interpreted the evidence and addressed different motor control problems related to daily life movements. The difficulties, uncertainties, and advances observed by faculties on students, as well as the students' perceptions about learning, satisfaction with the course activities, and grades of students, were described.

Results

The number of students indicating that the methodology was "always" or "almost always," promoting creative, analytical, or critical thinking was 70.5% [61.0-88.0%]. Satisfaction with the whole course was 97.0% [93.0-98.0%]. Laboratory grades were linearly associated to course grades with a regression coefficient of 0.53 and 0.43 R-squared (p < 0.001).

Conclusion

Integrating sEMG and kinematics technology with active learning into laboratory activities enhances students' engagement and understanding of human movement. This approach holds promises to improve teaching-learning processes, which were observed consistently across the cohorts of students.

Short-term foot warming impacts foot sensitivity and body sway differently in older adults

BACKGROUND

Aging is accompanied by loss of foot skin sensitivity and reduced postural control. Increasing foot temperature can improve both skin sensitivity and postural control in adults. However, it remains unclear whether similar effects can be observed in older adults.

RESEARCH QUESTION

Can foot warming improve postural control in older adults, similar to observations in younger adults?

METHODS

Two foot warming protocols were conducted in 18 older adults (14 women, 4 men) to increase foot temperature by using infrared radiation to (1) warm the plantar aspect and (2) the skin of the entire foot and ankle area. We assessed the foot skin sensitivity before and after warming, considering tactile stimulation and center of pressure (CoP) displacement during 30-s standing with eyes open and closed.

RESULTS AND SIGNIFICANCE

Both foot warming protocols led to similar increases in skin temperature (∼6 °C) compared to the basal condition, but only warming the entire foot and ankle area increased foot sensitivity for the different regions assessed. No main effects or interactions were found for CoP variables in response to the two warming protocols. The short-term effects identified after warming the entire foot and ankle region suggest that this might be a strategy to improve skin sensitivity in older adults as observed in younger adults, but this was not the case for CoP. Future research should clarify whether the magnitude and long-lasting effects of warming could be determinant of CoP results.

Effects of different hydration supports on stride kinematics, comfort, and impact accelerations during running

BACKGROUND

Different supports for hydration can influence total body mass and affect running biomechanics.

RESEARCH QUESTION

Do different hydration supports affect the perceived exertion and comfort, stride kinematics, and impact accelerations during running?

METHODS

This was a crossover study design. Thirteen trail runners completed a treadmill running test divided into four different durations and randomized hydration supports conditions, lasting 8 min each at moderate intensity: A) waist bag (0.84 kg); B) medium load backpack (0.84 kg); C) full load backpack (3.40 kg); and D) a control condition without water support. Impact accelerations were measured for 30 s in 4, 6, and 8 min. The rate of perceived exertion and heart rate were registered on minutes 4 and 8. At the last minute of each condition, comfort perception was registered RESULTS AND SIGNIFICANCE: No condition affected the stride kinematics. Full load backpack condition reduced head acceleration peak (-0.21 g; p = 0.04; ES=0.4) and head acceleration magnitude (-0.23 g; p = 0.03; ES=0.4), and increased shock attenuation (3.08 g; p = 0.04; ES=0.3). It also elicited higher perceived exertion (p < 0.05; ES>0.8) being considered heavier (p < 0.01; ES > 1.1). The waist bag condition was more comfortable in terms of noise (p = 0.006; ES=1.3) and humidity/heat (p = 0.001; ES=0.8). The waist bag was the most comfortable support. On the other hand, the full backpack elicited lower comfort and was the only generating compensatory adjustments. These results may help to improve design of full load backpack aiming at comfort for runners.

Effects of increasing temperature in different foot regions on foot sensitivity and postural control in young adults

Despite controversial evidence, foot sensitivity may influence postural control. Since skin temperature changes may induce changes in skin sensitivity, it remains unclear whether this also affects postural control. Here we examined the effects of increasing foot temperature on foot sensitivity and postural control responses. It is hypothesized that increases in foot temperature would improve foot sensitivity and enhance postural control. Furthermore, it was investigated whether warming a larger foot area provides additional benefits. Our hypothesis was tested by warming the foot plantar and the whole foot and ankle area (including foot plantar and instep) using infrared radiation and evaluated the center of pressure (CoP, bilateral, in two conditions: eyes open and eyes closed) and foot tactile sensitivity (Semmes-Weinstein Monofilaments) in 22 young participants. Both warming protocols significantly increased foot temperature by ∼5-6 °C and improved sensitivity, whereas more considerable improvements happened after warming the whole foot and ankle. CoP mediolateral oscillation and velocity with eyes open, and CoP area and velocity with eyes closed reduced after both warming protocols. Foot sensitivity seems to depend on the foot area warmed, whereas postural control improved equally regardless of the warmed regions. These results may support interventions based on the manipulation of foot temperatures to improve postural control with potential clinical applications in populations with impaired foot sensitivity and balance.

Influence of infrared camera model and evaluator reproducibility in the assessment of skin temperature responses to physical exercise

Infrared thermography (IRT) has been gaining in popularity in clinical and scientific research due to the increasing availability of affordable infrared cameras. This study aims to determine the similarity of measurement performance between three models of IRT camera during assessment of skin temperature before and after physical exercise. Three models of FLIR thermographic cameras (E60bx, Flir-One Pro LT, and C2) were tested. Thermal images were taken of the foot sole, anterior leg, and anterior thigh from 12 well-trained men, before and after a 30-min run on a treadmill. Image files were blinded and processed by three evaluators to extract the mean, maximum, and standard deviation of skin temperature of the region of interest. Time for data processing and rate of perceived effort was also recorded. Data processing was slower on the E60bx (CI95% E60 vs C2 [0.2, 2.6 min], p = 0.02 and ES = 0.6); vs. Flir-One [0.0, 3.4 min], p = 0.03 and ES = 0.6) and was associated with lower effort perception (E60 3.0 ± 0.1 vs. Flir-One 5.6 ± 0.2 vs C2 7.0 ± 0.2 points; p < 0.001 and ES > 0.8). The C2 and Flir-One cameras underestimated the temperature compared with the E60. In general, measuring mean temperature provided higher camera and examiner intra-class correlations than maximum and standard deviation, especially before exercise. Moreover, post exercise mean skin temperatures provided the most consistent values across cameras and evaluators. We recommend the use of mean temperature and caution when using more than one camera model in a study.

Winter School on sEMG Signal Processing: An Initiative to Reduce Educational Gaps and to Promote the Engagement of Physiotherapists and Movement Scientists With Science

The application of surface electromyography (sEMG) in neurology is sometimes limited by a scientific background in the use of sEMG. Students frequently use sEMG only when developing their graduate studies. To reduce these barriers, we promoted a free Winter School on sEMG to Latin American students. The school was a 3-day event with theoretical classes and computer programming in Matlab. Lectures were delivered in Portuguese and Spanish to 50 participants. All lectures were recorded and made available on YouTube®. After the School, participants completed a written exam to receive a certificate. The written exam revealed the average effectiveness of 71 ± 20% in the comprehension of topics addressed during the school. Participants rated the School as “excellent” and considered the event as having changed their thoughts about the use of sEMG. Limited mathematical skills or background were the main barriers identified to follow the lectures and to make use of sEMG. We conclude that the Winter School had a positive impact on participant's formation, especially by showing them the importance of continuous involvement with the concepts related to sEMG to become proficient in its use. From the participant's point of view, the activity was excellent and the follow up of the school on YouTube® suggests that combining face-to-face activities followed by the online availability of lectures is a valid strategy to reinforce the learning process and to reduce barriers in the use of sEMG. Whether similar results would be achieved for a paid registration event in an economically developing region, still requires further investigation.

Green Tea Extract Preserves Neuromuscular Activation and Muscle Damage Markers in Athletes Under Cumulative Fatigue

A main implication of cumulative fatigue is the muscle damage that impairs neuromuscular function and training adaptations. These negative effects may limit performance when athletes exercise in consecutive days. In this regard, antioxidant supplementation has gain popularity among athletes. Green tea supplementation has been advocated as a strategy to improve exercise recovery due to the activity of its catechins with high antioxidant and anti-inflammatory potential. Here we performed a triple blinded placebo control experiment to determine the effect of green tea extract (GTE) from Camellia sinensis on muscle damage, oxidative stress, and neuromuscular activity in athletes submitted to consecutive sessions of exercise and fatigue. Sixteen trained amateur male athletes were randomly assigned to a GTE supplemented (500 mg/day) or placebo group during 15 days. Effects of supplementation were tested during repeated trials of submaximal cycling at 60% of peak power output performed after a protocol for cumulative fatigue of knee extensors. Muscle damage and oxidative stress showed lower magnitudes in response to fatigue after GTE supplementation. Placebo group showed impaired neuromuscular activity and higher muscle damage and oxidative stress compared to the GTE group during the cycling trials under fatigue. In summary, GTE supplementation showed positive effects on neuromuscular function in response to a condition of cumulative fatigue. It suggests GTE supplementation may have potential to serve as a strategy to improve performance and recovery in conditions of cumulative exercise.

Effects of plantar foot sensitivity manipulation on postural control of young adult and elderly

INTRODUCTION

Subjects with sensorial losses present balance deficits. Although such condition is often observed among elderly, there is discussion concerning the dependence on sensorial information for body sway control in the elderly without sensorial losses.

PURPOSE

We investigated the effects of foot sensitivity manipulation on postural control during upright standing in young adults and independent elderly (n=19/group).

METHODS

Plantar sensitivity was evaluated by esthesiometry, and speed of center of pressure shift data during upright posture were evaluated for each foot using a baropodometer while the subjects were standing with eyes open or closed. The young adult group was evaluated for center of pressure in normal conditions and after plantar sensitivity disturbance, by immersing their feet in water and ice.

RESULTS

Young adults did not show alterations in their center of pressure after sensorial perturbation and presented, even under sensorial perturbation, better postural control than elderly subjects. The elderly showed lower foot sensitivity and greater center of pressure oscillation than young adults.

CONCLUSION

Elderly subjects seem to rely more on foot sensitivity for control of body sway than young adults. In the elderly, a clinical intervention to improve foot sensitivity may help in upright posture maintenance.

Plantar Pressure and Foot Temperature Responses to Acute Barefoot and Shod Running

Purpose. Increased contact pressure and skin friction may lead to higher skin temperature. Here, we hypothesized a relationship between plantar pressure and foot temperature. To elicit different conditions of stress to the foot, participants performed running trials of barefoot and shod running. Methods. Eighteen male recreational runners ran shod and barefoot at a self-selected speed for 15 min over different days. Before and immediately after running, plantar pressure during standing (via a pressure mapping system) and skin temperature (using thermography) were recorded. Results. No significant changes were found in plantar pressure after barefoot or shod conditions (p > 0.9). Shod running elicited higher temperatures in the forefoot (by 0.5-2.2°C or 0.1-1.2% compared with the whole foot, p < 0.01) and midfoot (by 0.9-2.4°C, p < 0.01). Barefoot running resulted in higher temperature variation in the rearfoot (0.1-10.4%, p = 0.04). Correlations between skin temperature and plantar pressure were not significant (r < 0.5 and r > -0.5, p > 0.05). Conclusions. The increase in temperature after the shod condition was most likely the result of footwear insulation. However, variation of the temperature in the rearfoot was higher after barefoot running, possible due to a higher contact load. Changes in temperature could not predict changes in plantar pressure and vice-versa.