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Long-Term Use Of An Ankle-Foot Orthosis Intervention In Patients With Peripheral Artery Disease Using The Integrated Promoting Action On Research Implementation In Health Services (I-Parihs) Framework, Ayisha Bashir, Danae Dinkel, Iraklis Pipinos, Paul Estabrooks, Jason Johanning, Sara A. Myers

Journal Articles

Background

Peripheral artery disease (PAD) is a cardiovascular disease that limits patients' walking ability. Persistent ankle-foot orthosis (AFO) use may increase the distance patients can walk as well as physical activity.

Purpose

The purpose of the study was to determine the implementation and patients' perspectives related to the use or disuse of the AFO intervention six months post-intervention. This study was guided by a semi-structured interview and survey based on the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) constructs.

Design

A convergent mixed methods design was used to evaluate participants' perceptions six months following a three-month AFO …

Joint Angle Variability Is Altered In Patients With Peripheral Artery Disease After Six Months Of Exercise Intervention, Farah Fallahtafti, Zahra Salamifar, Mahdi Hassan, Hafizur Rahman, Iraklis Pipinos, Sara A. Myers

Journal Articles

Supervised exercise therapy (SET) is a conservative non-operative treatment strategy for improving walking performance in patients with peripheral artery disease (PAD). Gait variability is altered in patients with PAD, but the effect of SET on gait variability is unknown. Forty-three claudicating patients with PAD underwent gait analysis before and immediately after a 6-month SET program. Nonlinear gait variability was assessed using sample entropy, and the largest Lyapunov exponent of the ankle, knee, and hip joint angle time series. Linear mean and variability of the range of motion time series for these three joint angles were also calculated. Two-factor repeated measure …

Machine Learning-Based Peripheral Artery Disease Identification Using Laboratory-Based Gait Data, Ali Al-Ramini, Mahdi Hassan, Farah Fallahtafti, Mohammad Ali Takallou, Hafizur Rahman, Basheer Qolomany, Iraklis Pipinos, Fadi Alsaleem, Sara A. Myers

Journal Articles

Peripheral artery disease (PAD) manifests from atherosclerosis, which limits blood flow to the legs and causes changes in muscle structure and function, and in gait performance. PAD is underdiagnosed, which delays treatment and worsens clinical outcomes. To overcome this challenge, the purpose of this study is to develop machine learning (ML) models that distinguish individuals with and without PAD. This is the first step to using ML to identify those with PAD risk early. We built ML models based on previously acquired overground walking biomechanics data from patients with PAD and healthy controls. Gait signatures were characterized using ankle, knee, …

Patient Compliance With Wearing Lower Limb Assistive Devices: A Scoping Review, Ayisha Bashir, Danae Dinkel, Iraklis Pipinos, Jason Johanning, Sara Myers

Journal Articles

Objective

The aim of this scoping review was to identify information on compliance with wearing orthoses and other supportive devices, to discuss the barriers to adherence, and to suggest strategies for improvement based on these findings.

Methods

Online databases of PubMed, Web of Science, and the Cochrane Library were searched for articles about patients’ compliance with regard to lower limb assistive devices. In addition, a methodological quality control process was conducted. Studies were included if in the English language and related to compliance and adherence to the lower limb assistive device. Exclusion was based on first reading the abstract …

Peripheral Artery Disease Affects The Function Of The Legs Of Claudicating Patients In A Diffuse Manner Irrespective Of The Segment Of The Arterial Tree Primarily Involved, Todd Leutzinger, Panagiotis Koutakis, Matthew A. Fuglestad, Hafizur Rahman, Holly Despiegelaere, Mahdi Hassan, Molly Schieber, Jason Johanning, Nick Stergiou, G. Matthew Longo, George P. Casale, Sara A. Myers, Iraklis Pipinos

Journal Articles

Different levels of arterial occlusive disease (aortoiliac, femoropopliteal, multi-level disease) can produce claudication symptoms in different leg muscle groups (buttocks, thighs, calves) in patients with peripheral artery disease (PAD). We tested the hypothesis that different locations of occlusive disease uniquely affect the muscles of PAD legs and produce distinctive patterns in the way claudicating patients walk. Ninety-seven PAD patients and 35 healthy controls were recruited. PAD patients were categorized to aortoiliac, femoropopliteal and multi-level disease groups using computerized tomographic angiography. Subjects performed walking trials both pain-free and during claudication pain and joint kinematics, kinetics, and spatiotemporal parameters were calculated to …

Midlands Voices: We Need To Do More To Support Expecting Mothers During And After Pregnancy, Sara A. Myers

Journal Articles

No abstract provided.

Development Of A Rural Childcare Professionals Advisory Board Focused On Mental And Physical Wellbeing, Danae Dinkel, John Rech, Natalie Hanna, Denita Julius, Jennifer Bauman, Tonya Hood-Hytrek, Matthew Bice

Journal Articles

Background. Childcare providers have high rates of stress and obesity, which can have an impact on the care they provide for children. Limited research has described strategies for including childcare providers in the development of wellbeing initiatives, especially in rural areas.
Objective. To describe the creation and acceptability of a rural childcare advisory board focused on childcare providers’ wellbeing as well as the acceptability of a wellbeing summit implemented by the board.
Methods. A collaborative model guided the actions of the advisory board. Acceptability of the board and the summit were assessed via surveys.
Results. Key factors contributing to the …

Assessing Wear Time And Perceptions Of Wearing An Ankle Foot Orthosis In Patients With Peripheral Artery Disease, Danae Dinkel, Mahdi Hassan, Holly Despiegelaere, Jason Johanning, Iraklis Pipinos, Sara Myers

Journal Articles

Background

Peripheral artery disease (PAD) is a cardiovascular disease that affects walking ability. An ankle foot orthosis (AFO) may improve walking distances in those with PAD. Little research has explored if those with PAD wear a prescribed AFO and their perceptions of wearing the device.

Objective

To assess wear time of an AFO and explore perceptions of wearing the device in patients with PAD.

Design

Convergent mixed methods.

Setting

The study was conducted through a tertiary care medical center, and the research participants used the device in the community.

Participants

Thirty-six patients, all older adult males, were enrolled in this …

Assessing Wear Time And Perceptions Of Wearing An Ankle Foot Orthosis In Patients With Peripheral Artery Disease, Danae Dinkel, Mahdi Hassan, John Rech, Holly Despiegelaere, Jason Johanning, Iraklis Pipinos, Sara A. Myers

Journal Articles

Background

Peripheral artery disease (PAD) is a cardiovascular disease that affects walking ability. An ankle foot orthosis (AFO) may improve walking distances in those with PAD. Little research has explored if those with PAD wear a prescribed AFO and their perceptions of wearing the device.

Objective

To assess wear time of an AFO and explore perceptions of wearing the device in patients with PAD.

Design

Convergent mixed methods.

Setting

The study was conducted through a tertiary care medical center, and the research participants used the device in the community.

Participants

Thirty-six patients, all older adult males, were enrolled in this …

Qualitative Analysis Of Colorectal Cancer Screening In Rural Nebraska, Kendra L. Ratnapradipa, Krishtee Napit, Jordan Ranta, Lady Beverly Luma, Danae Dinkel, Tamara Robinson, Laura Schabloske, Shinobu Watanabe-Galloway

Journal Articles

Compared to urban residents, rural populations are less likely to engage in colorectal cancer (CRC) screening. As part of a statewide cancer needs assessment, we aimed to elicit rural perspectives about CRC screening and resources. We conducted three focus groups with rural Nebraska cancer survivors and caregivers (N = 20) in Spring 2021 using a collective case study design. Participant awareness of and knowledge about CRC screening methods varied across focus groups; overall, 95% of participants had heard of colonoscopy. Participants were less familiar with fecal tests and had confusion about them. Colonoscopy was associated with negative perceptions regarding …

Qualitative Analysis Of Cancer Care Experiences Among Rural Cancer Survivors And Caregivers, Kendra L. Ratnapradipa, Jordan Ranta, Krishtee Napit, Lady Beverly Luma, Tamara Robinson, Danae Dinkel, Laura Schabloske, Shinobu Watanabe-Galloway

Journal Articles

Purpose

Rural (vs urban) patients experience poorer cancer outcomes and are less likely to be engaged in cancer prevention, such as screening. As part of a community needs assessment, we explored rural cancer survivors’ and caregivers’ experiences, perceptions, and attitudes toward cancer care services.

Methods

We conducted 3 focus groups (N = 20) in Spring 2021 in rural Nebraska.

Findings

Three patterns of cancer diagnosis were regular care/screening without noticeable symptoms, treatment for symptoms not initially identified as cancer related, and symptom self-identification. Most participants, regardless of how diagnosis was made, had positive experiences with timely referral for testing (imaging …

Metabolically Efficient Walking Assistance Using Optimized Timed Forces At The Waist, Prokopios Antonellis, Arash Mohammadzadeh Gonabadi, Sara Myers, Iraklis Pipinos, Philippe Malcolm

Journal Articles

The metabolic rate of walking can be reduced by applying a constant forward force at the center of mass. It has been shown that the metabolically optimal constant force magnitude minimizes propulsion ground reaction force at the expense of increased braking. This led to the hypothesis that selectively assisting propulsion could lead to greater benefits. We used a robotic waist tether to evaluate the effects of forward forces with different timings and magnitudes. Here, we show that it is possible to reduce the metabolic rate of healthy participants by 48% with a greater efficiency ratio of metabolic cost reduction per …

Muscle Forces And Power Are Significantly Reduced During Walking In Patients With Peripheral Artery Disease, Hafizur Rahman, Cody Anderson, Iraklis Pipinos, Jason Johanning, George P. Casale, Jianghu Dong, Holly Despiegelaere, Mahdi Hassan, Sara A. Myers

Journal Articles

Patients with peripheral artery disease (PAD) have significantly reduced lower extremity muscle strength compared with healthy individuals as measured during isolated, single plane joint motion by isometric and isokinetic strength dynamometers. Alterations to the force contribution of muscles during walking caused by PAD are not well understood. Therefore, this study used simulations with PAD biomechanics data to understand lower extremity muscle functions in patients with PAD during walking and to compare that with healthy older individuals. A total of 12 patients with PAD and 10 age-matched healthy older controls walked across a 10-meter pathway with reflective markers on their …

How Capuchin Monkeys Use Their Semi-Prehensile Tails, Madhur Mangalam, Callum F. Ross, Patricia Izar, Elisabetta Visalberghi, Dorothy M. Fragaszy

Journal Articles

Among primates, prehensile/semi-prehensile tails have evolved independently in the families Atelidae and Cebidae of the infraorder Platyrrhini (Neotropical monkeys). They facilitate maintaining stability during locomotion on thin, flexible branches and while reaching for food on challenging substrates. How a prehensile/semi-prehensile tail is coordinated with the hind limbs to facilitate controlled, flexible adoption of postures remains unknown. In an experimental set-up in the wild, we induced capuchin monkeys to adopt a tail-assisted, head-down tripodal posture to reach for food, documenting from slow-motion video recordings (120 fps) both qualitative changes in the monkeys’ positional behaviour – the relative orientation of their limbs …

A Kinematic And Emg Dataset Of Online Adjustment Of Reach-To-Grasp Movements To Visual Perturbations, Mariusz P. Furmanek, Madhur Mangalam, Matthew Yarossi, Kyle Lockwood, Eugene Tunik

Journal Articles

Control of reach-to-grasp movements for deft and robust interactions with objects requires rapid sensorimotor updating that enables online adjustments to changing external goals (e.g., perturbations or instability of objects we interact with). Rarely do we appreciate the remarkable coordination in reach-to-grasp, until control becomes impaired by neurological injuries such as stroke, neurodegenerative diseases, or even aging. Modeling online control of human reach-to-grasp movements is a challenging problem but fundamental to several domains, including behavioral and computational neuroscience, neurorehabilitation, neural prostheses, and robotics. Currently, there are no publicly available datasets that include online adjustment of reach-to-grasp movements to object perturbations. This …

A Robust Technique For Optimal Fitting Of Roll-Over Shapes Of Human Locomotor Systems, Ganesh M. Bapat, Sara A. Myers

Journal Articles

The roll-over shape (ROS) effectively characterizes the lower limb's ability to roll forward during the single-limb support phase of human walking. ROS is modelled as an optimally fitted circular arc to the center of pressure (CoP) data transformed in the shank/leg-based local coordinate system. The commonly used method for optimal fitting of ROS is complex to implement and eliminates inherent individual variability in the ROS parameters during walking. We propose and validate a novel computerized method for optimal fitting of roll-over shapes of the lower limb during walking. Gait data of a healthy individual from Winter's book was used …