Objective: To explore the usability and feasibility of a downloadable application (APP) compared to paper handouts (CONTROL) in guiding 30 days of PT-prescribed home exercise after total knee arthroplasty (TKA), and t...Objective: To explore the usability and feasibility of a downloadable application (APP) compared to paper handouts (CONTROL) in guiding 30 days of PT-prescribed home exercise after total knee arthroplasty (TKA), and to compare functional outcomes at 30 days postoperatively between APP and CONTROL. Design: Randomized controlled usability and feasibility study. Setting: Rehabilitation laboratories at two regional medical centers. Participants: Individuals with knee osteoarthritis undergoing unilateral TKA (APP group: N = 26;mean age, 67.0 ± 8.2 y;CONTROL group: N = 31;mean age, 64.7 ± 7.7 y). Interventions: This study assessed the user experience of a downloadable app to guide 30 days of home exercises and instruction after TKA and compared exploratory outcomes to a group using paper handouts. Main Outcome Measures: The System Usability Scale (SUS) score was used to assess patient usability experience. Raw SUS scores were dichotomized (≥72% or <72%) to determine app usability against a 75% a priori criterion for mean APP group score. Feasibility for app use was similarly evaluated in the APP group only through a priori criteria applied to computing device ownership and study use, to the absence of technology-based barriers to participation, and to completion of app-based testing. Exploratory measures compared change from baseline to 30 days for functional and patient-reported outcomes between APP and CONTROL. Results: The APP group’s mean SUS score of 79.2% at 30 days exceeded the 75% threshold for good usability. The app met the predetermined a priori feasibility criteria for absence of technology-based barriers to participation (75% of participants) and completion of app-based testing (91.3% of participants). Personal computing devices were used by 71.4% of APP participants, which was below the 75% a priori feasibility criterion. No differences between the APP and CONTROL groups were observed for functional or patient-reported outcomes. Conclusions: The app-based platform met the a priori criteria for usability for 79% of APP participants. Our findings suggest that app-based, avatar-guided home exercise after TKA has acceptable usability and feasibility. The app-guided patient assessment capability also demonstrates preliminary feasibility for guiding and administering functional and self-reported outcomes assessments.展开更多
Participation in ultramarathon events has grown substantially in the past decade.However,poor understanding of the physiological outcomes associated with participation in this sport prevents athletes and clinicians fr...Participation in ultramarathon events has grown substantially in the past decade.However,poor understanding of the physiological outcomes associated with participation in this sport prevents athletes and clinicians from adequately addressing performance and recovery tactics.The purpose of this review was to summarize developments in the literature in the last 10 years regarding acute and chronic responses to ultramarathon running with a focus on the peripheral vascular system,neuromuscular outcomes,and running mechanics.Evidence suggests that there are acute impairments in large artery compliance especially following the longer ultramarathon distances.However,most literature indicates that chronic vascular impairments are not evident in ultramarathon runners.Both central and peripheral fatigue mechanisms contribute to declines in muscle force production that may last up to several weeks in some muscles following an ultramarathon.Alterations in gait kinematics and skeletal muscle oxidative capacity increase the metabolic cost of running over prolonged running distances(>4 h).Several factors such as elevation changes and nutritional practices make interpretation of findings challenging.Future studies are needed to better understand the interplay among systems and how external factors contribute to these outcomes to optimize performance and inform recovery strategies in this increasingly popular sport.展开更多
文摘Objective: To explore the usability and feasibility of a downloadable application (APP) compared to paper handouts (CONTROL) in guiding 30 days of PT-prescribed home exercise after total knee arthroplasty (TKA), and to compare functional outcomes at 30 days postoperatively between APP and CONTROL. Design: Randomized controlled usability and feasibility study. Setting: Rehabilitation laboratories at two regional medical centers. Participants: Individuals with knee osteoarthritis undergoing unilateral TKA (APP group: N = 26;mean age, 67.0 ± 8.2 y;CONTROL group: N = 31;mean age, 64.7 ± 7.7 y). Interventions: This study assessed the user experience of a downloadable app to guide 30 days of home exercises and instruction after TKA and compared exploratory outcomes to a group using paper handouts. Main Outcome Measures: The System Usability Scale (SUS) score was used to assess patient usability experience. Raw SUS scores were dichotomized (≥72% or <72%) to determine app usability against a 75% a priori criterion for mean APP group score. Feasibility for app use was similarly evaluated in the APP group only through a priori criteria applied to computing device ownership and study use, to the absence of technology-based barriers to participation, and to completion of app-based testing. Exploratory measures compared change from baseline to 30 days for functional and patient-reported outcomes between APP and CONTROL. Results: The APP group’s mean SUS score of 79.2% at 30 days exceeded the 75% threshold for good usability. The app met the predetermined a priori feasibility criteria for absence of technology-based barriers to participation (75% of participants) and completion of app-based testing (91.3% of participants). Personal computing devices were used by 71.4% of APP participants, which was below the 75% a priori feasibility criterion. No differences between the APP and CONTROL groups were observed for functional or patient-reported outcomes. Conclusions: The app-based platform met the a priori criteria for usability for 79% of APP participants. Our findings suggest that app-based, avatar-guided home exercise after TKA has acceptable usability and feasibility. The app-guided patient assessment capability also demonstrates preliminary feasibility for guiding and administering functional and self-reported outcomes assessments.
文摘Participation in ultramarathon events has grown substantially in the past decade.However,poor understanding of the physiological outcomes associated with participation in this sport prevents athletes and clinicians from adequately addressing performance and recovery tactics.The purpose of this review was to summarize developments in the literature in the last 10 years regarding acute and chronic responses to ultramarathon running with a focus on the peripheral vascular system,neuromuscular outcomes,and running mechanics.Evidence suggests that there are acute impairments in large artery compliance especially following the longer ultramarathon distances.However,most literature indicates that chronic vascular impairments are not evident in ultramarathon runners.Both central and peripheral fatigue mechanisms contribute to declines in muscle force production that may last up to several weeks in some muscles following an ultramarathon.Alterations in gait kinematics and skeletal muscle oxidative capacity increase the metabolic cost of running over prolonged running distances(>4 h).Several factors such as elevation changes and nutritional practices make interpretation of findings challenging.Future studies are needed to better understand the interplay among systems and how external factors contribute to these outcomes to optimize performance and inform recovery strategies in this increasingly popular sport.
