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Background: Recent shoulder injury prevention programs have utilized resistance exercises combined with different forms of instability, with the goal of eliciting functional adaptations and thereby reducing the risk of injury. However, it is still unknown how an unstable weight mass (UWM) affects the muscular activity of the shoulder stabilizers. Aim of the study was to assess neuromuscular activity of dynamic shoulder stabilizers under four conditions of stable and UWM during three shoulder exercises. It was hypothesized that a combined condition of weight with UWM would elicit greater activation due to the increased stabilization demand.
Methods: Sixteen participants (7 m/9 f) were included in this cross-sectional study and prepared with an EMG-setup for the: Mm. upper/lower trapezius (U.TA/L.TA), lateral deltoid (DE), latissimus dorsi (LD), serratus anterior (SA) and pectoralis major (PE). A maximal voluntary isometric contraction test (MVIC; 5 s.) was performed on an isokinetic dynamometer. Next, internal/external rotation (In/Ex), abduction/adduction (Ab/Ad) and diagonal flexion/extension (F/E) exercises (5 reps.) were performed with four custom-made-pipes representing different exercise conditions. First, the empty-pipe (P; 0.5 kg) and then, randomly ordered, water-filled-pipe (PW; 1 kg), weight-pipe (PG; 4.5 kg) and weight + water-filled-pipe (PWG; 4.5 kg), while EMG was recorded. Raw root-mean-square values (RMS) were normalized to MVIC (%MVIC). Differences between conditions for RMS%MVIC, scapular stabilizer (SR: U.TA/L.TA; U.TA/SA) and contraction (CR: concentric/eccentric) ratios were analyzed (paired t-test; p ≤ 0.05; Bonferroni adjusted α = 0.008).
Results: PWG showed significantly greater muscle activity for all exercises and all muscles except for PE compared to P and PW. Condition PG elicited muscular activity comparable to PWG (p > 0.008) with significantly lower activation of L.TA and SA in the In/Ex rotation. The SR ratio was significantly higher in PWG compared to P and PW. No significant differences were found for the CR ratio in all exercises and for all muscles.
Conclusion: Higher weight generated greater muscle activation whereas an UWM raised the neuromuscular activity, increasing the stabilization demands. Especially in the In/Ex rotation, an UWM increased the RMS%MVIC and SR ratio. This might improve training effects in shoulder prevention and rehabilitation programs.
Electric drive systems are increasingly used in automobiles. However, the combination of comfort, dynamics and safety requirements places high demands on the torque accuracy. The complex interplay of battery, inverter and electrical machine causes a lot of system uncertainties based on parameter fluctuations and measurement errors that influence the system performance. In this paper these influences on the closed loop torque control are analyzed and quantified using a variance based sensitivity analysis. The method enables to connect the variance of the torque accuracy with the parameter uncertainties causing this variance. Moreover, it quantifies the influences of the parameters independent of the complexity of the analyzed system. In addition, two methods to ensure convergence of the estimated variance based sensitivity measures are proposed. The results of the analysis are presented for 19 static working points of an battery electric drive system.
Deep brain stimulation (DBS) is an established therapy for movement disorders such as in Parkinson's disease (PD) and essential tremor (ET). Adjusting the stimulation parameters, however, is a labour-intensive process and often requires several patient visits. Physicians prefer objective tools to improve (or maintain) the performance in DBS. Wearable motion sensors (WMS) are able to detect some manifestations of pathological signs, such as tremor in PD. However, the interpretation of sensor data is often highly technical and methods to visualise tremor data of patients undergoing DBS in a clinical setting are lacking. This work aims to visualise the dynamics of tremor responses to DBS parameter changes with WMS while patients performing clinical hand movements. To this end, we attended DBS programming sessions of two patients with the aim to visualise certain aspects of the clinical examination. PD tremor and ET were effectively quantified by acceleration amplitude and frequency. Tremor dynamics were analysed and visualised based on setpoints, movement transitions and stability aspects. These methods have not yet been employed and examples demonstrate how tremor dynamics can be visualised with simple analysis techniques. We therefore provide a base for future research work on visualisation tools in order to assist clinicians who frequently encounter patients for DBS therapy. This could lead to benefits in terms of enhanced evaluation of treatment efficacy in the future.
Background: The Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings. However, the MSK-HQ needs to be further evaluated across settings and different languages.
Objective: The objective of the study was to evaluate and compare measurement properties of the MSK-HQ across Danish (DK) and English (UK) cohorts of patients from primary care physiotherapy services with musculoskeletal pain.
Methods: MSK-HQ was translated into Danish according to international guidelines. Measurement invariance was assessed by differential item functioning (DIF) analyses. Test-retest reliability, measurement error, responsiveness and minimal clinically important change (MCIC) were evaluated and compared between DK (n = 153) and UK (n = 166) cohorts.
Results: The Danish version demonstrated acceptable face and construct validity. Out of the 14 MSK-HQ items, three items showed DIF for language (pain/stiffness at night, understanding condition and confidence in managing symptoms) and three items showed DIF for pain location (walking, washing/dressing and physical activity levels). Intraclass Correlation Coefficients for test-retest were 0.86 (95% CI 0.81 to 0.91) for DK cohort and 0.77 (95% CI 0.49 to 0.90) for the UK cohort. The systematic measurement error was 1.6 and 3.9 points for the DK and UK cohorts respectively, with random measurement error being 8.6 and 9.9 points. Receiver operating characteristic (ROC) curves of the change scores against patients’ own judgment at 12 weeks exceeded 0.70 in both cohorts. Absolute and relative MCIC estimates were 8–10 points and 26% for the DK cohort and 6–8 points and 29% for the UK cohort.
Conclusions: The measurement properties of MSK-HQ were acceptable across countries, but seem more suited for group than individual level evaluation. Researchers and clinicians should be aware that some discrepancy exits and should take the observed measurement error into account when evaluating change in scores over time.
The objective investigation of the dynamic properties of vocal fold vibrations demands the recording and further quantitative analysis of laryngeal high-speed video (HSV). Quantification of the vocal fold vibration patterns requires as a first step the segmentation of the glottal area within each video frame from which the vibrating edges of the vocal folds are usually derived. Consequently, the outcome of any further vibration analysis depends on the quality of this initial segmentation process. In this work we propose for the first time a procedure to fully automatically segment not only the time-varying glottal area but also the vocal fold tissue directly from laryngeal high-speed video (HSV) using a deep Convolutional Neural Network (CNN) approach. Eighteen different Convolutional Neural Network (CNN) network configurations were trained and evaluated on totally 13,000 high-speed video (HSV) frames obtained from 56 healthy and 74 pathologic subjects. The segmentation quality of the best performing Convolutional Neural Network (CNN) model, which uses Long Short-Term Memory (LSTM) cells to take also the temporal context into account, was intensely investigated on 15 test video sequences comprising 100 consecutive images each. As performance measures the Dice Coefficient (DC) as well as the precisions of four anatomical landmark positions were used. Over all test data a mean Dice Coefficient (DC) of 0.85 was obtained for the glottis and 0.91 and 0.90 for the right and left vocal fold (VF) respectively. The grand average precision of the identified landmarks amounts 2.2 pixels and is in the same range as comparable manual expert segmentations which can be regarded as Gold Standard. The method proposed here requires no user interaction and overcomes the limitations of current semiautomatic or computational expensive approaches. Thus, it allows also for the analysis of long high-speed video (HSV)-sequences and holds the promise to facilitate the objective analysis of vocal fold vibrations in clinical routine. The here used dataset including the ground truth will be provided freely for all scientific groups to allow a quantitative benchmarking of segmentation approaches in future.
This study compares the environmental impacts of petrol, diesel, natural gas, and electric vehicles using a process-based attributional life cycle assessment (LCA) and the ReCiPe characterization method that captures 18 impact categories and the single score endpoints. Unlike common practice, we derive the cradle-to-grave inventories from an originally combustion engine VW Caddy that was disassembled and electrified in our laboratory, and its energy consumption was measured on the road. Ecoivent 2.2 and 3.0 emission inventories were contrasted exhibiting basically insignificant impact deviations. Ecoinvent 3.0 emission inventory for the diesel car was additionally updated with recent real-world close emission values and revealed strong increases over four midpoint impact categories, when matched with the standard Ecoinvent 3.0 emission inventory. Producing batteries with photovoltaic electricity instead of Chinese coal-based electricity decreases climate impacts of battery production by 69%. Break-even mileages for the electric VW Caddy to pass the combustion engine models under various conditions in terms of climate change impact ranged from 17,000 to 310,000 km. Break-even mileages, when contrasting the VW Caddy and a mini car (SMART), which was as well electrified, did not show systematic differences. Also, CO2-eq emissions in terms of passenger kilometers travelled (54–158 g CO2-eq/PKT) are fairly similar based on 1 person travelling in the mini car and 1.57 persons in the mid-sized car (VW Caddy). Additionally, under optimized conditions (battery production and use phase utilizing renewable electricity), the two electric cars can compete well in terms of CO2-eq emissions per passenger kilometer with other traffic modes (diesel bus, coach, trains) over lifetime. Only electric buses were found to have lower life cycle carbon emissions (27–52 g CO2-eq/PKT) than the two electric passenger cars.
Irrigated paddy rice agriculture accounts for a major share of Asia Pacific’s total water withdrawal. Furthermore, climate change induced water scarcity in the Asia-Pacific region is projected to intensify in the near future. Therefore, methods to reduce water consumption through efficiency measures are needed to ensure the long-term (water) sustainability. The irrigation systems, subak of Karangasem, Indonesia, and the tameike of Kunisaki, Japan, are two examples of sustainable paddy rice irrigation. This research, through interviews and an extensive survey, comparatively assessed the socio-environmental sustainability of the two irrigation management systems with special reference to the intensity and nature of social capital, equity of water distribution, water demand, water footprint, and water quality, etc. The prevailing social capital paradigm of each system was also compared to its overall managerial outcomes to analyze how cooperative action contributes to sustainable irrigation management. Both systems show a comparable degree of sustainable irrigation management, ensuring an equitable use of water, and maintain relatively fair water quality due to the land-use practices adapted. However, the systems differ in water demand and water efficiency principally because of the differences in the irrigation management strategies: human and structural. These findings could help devise mechanisms for transitioning to sustainable irrigation management in the commercially-oriented paddy rice agricultural systems across the Asia-Pacific region.
Stratified care for low back pain (LBP) has been shown to be clinically- and cost-effective in the UK, but its transferability to the German healthcare system is unknown. This study explores LBP patients’ perspectives regarding future implementation of stratified care, through in-depth interviews (n = 12). The STarT-Back-Tool was completed by participants prior to interviews. Interview data were analysed using Grounded Theory. The overarching theme identified from the data was ‘treatment-success’, with subthemes of ‘assessment and treatment planning’, ‘acceptance of the questionnaire’ and ‘contextual factors’. Patients identified the underlying cause of pain as being of great importance (whereas STarT-Back allocates treatment based on prognosis). The integration of the STarT-Back-Tool in consultations was considered helpful as long as it does not disrupt the therapeutic relationship, and was acceptable if tool results are handled confidentially. Results indicate that for patients to find STarT-Back acceptable, the shift from a focus on identifying a cause of pain and subsequent diagnosis, to prediction-orientated treatment planning, must be made clear. Patient ‘buy in’ is important for successful uptake of clinical interventions, and findings can help to inform future strategies for implementing STarT-Back in the Germany, as well as having potential implications for transferability to other similar healthcare systems.
For the assessment of human reaction time, a test environment was developed. This system consists of an embedded device with organic light-emitting diode (OLED) displays with push buttons for the combined presentation of visual stimulation and registration of the haptic human reaction. The test leader can define the test sequence with the aid of a graphical user interface (GUI) on a personal computer (PC). The validation of the system was proved by measuring the latency times of the whole system, which are conditioned by the specific hard- and software constellation. Through the investigation of the display’s light radiation by a photodiode and the recorded current consumption, latency times and their variance were specified. In the fastest mode the system can reach an error limit of 60 μs.