Kinesiology Commons^™

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, 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 …

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 …

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 …

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 …

Early Impact Of The Covid-19 Pandemic On Promotion Of Infant Activity, Strength And Communication: A Qualitative Exploration, Kailey Snyder, Priyanka Chaudhary, Angela Pereira, Kimberly Masuda, Jessica Niski, Danae Dinkel

Journal Articles

Introduction

Fostering physical activity, muscle strengthening and communication skills in diverse environments are vital to ensuring healthy infant development; however, promotion of these skills may be impacted by the COVID-19 pandemic. Therefore, the purpose of this study was to explore healthcare workers, parents and childcare providers' perceptions of the pandemic's influence on how they engage with infants to promote physical activity, muscle strength and communication.

Methods

37 subjects (12 = parents; 12 = childcare providers, 13 = healthcare workers) participated in a semi-structured interview. Data were analyzed via an inductive content analysis.

Results

The majority of caregivers identified concerns related …

Claudicating Patients With Peripheral Artery Disease Have Meaningful Improvement In Walking Speed After Supervised Exercise Therapy, Hafizur Rahman, Iraklis Pipinos, Jason M. Johanning, George P. Casale, Mark A. Williams, Jonathan R. Thompson, Yohanis O'Neill-Casto, Sara A. Myers

Journal Articles

Objective

Supervised exercise therapy (SET) is a first-line treatment for patients with peripheral artery disease (PAD). The efficacy of SET is most commonly expressed by significant statistical improvement of parameters that do not clarify how each individual patient will benefit from SET. This study examined the minimal clinically important difference (MCID) in walking speed in claudicating patients with PAD after SET.

Methods

A total of 63 patients with PAD-related claudication (Fontaine stage II PAD) participated in a 6-month SET program. Self-selected walking speed was measured before and after SET. Distribution and anchor-based approaches were used to estimate the MCID for …

Physical Activity, Physical Well-Being, And Psychological Well-Being: Associations With Life Satisfaction During The Covid-19 Pandemic Among Early Childhood Educators, Ken Randall, Timothy G. Ford, Kyong-Ah Kwon, Susan Sisson, Matthew Bice, Danae Dinkel, Jessica Tsotsoros

Journal Articles

Seeking personal well-being and life satisfaction during a global pandemic can be daunting, such is the case for early care and education teachers who were considered non-health care essential workers during the COVID-19 pandemic. The potential changes in their physical activity, along with their overall physical and psychological well-being, may have ultimately influenced their life satisfaction. These changes included the potential for increased sedentary behaviors. Despite the high health risks associated with these factors during the pandemic, the role of physical activity in early care and education teachers’ well-being and life satisfaction remains largely unknown. The purpose of this study …

A Qualitative Comparison Of Parent And Childcare Provider Perceptions Of Communication And Family Engagement In Children's Healthy Eating And Physical Activity, Danae Dinkel, Maggie Rasmussen, John Rech, Kailey Snyder, Dipti A. Dev

Journal Articles

Background

Parents and childcare providers play a substantial role in the development of health behaviours among the children they care for. In order to ensure the optimal growth and development of children, communication and family engagement in childcare is critical. Previous studies examining parent or provider perceptions about healthy eating or physical activity have explored these concepts individually and/or have only included only parents or providers. Therefore, the purpose of this study was to compare childcare provider and parent perceptions of communication regarding healthy eating and physical activity as well as use of best practice strategies on family engagement for …

Examining Supports And Barriers To Breastfeeding Through A Socio-Ecological Lens: A Qualitative Study, Kailey Snyder, Emily Hulse, Holly Dingman, Angie Cantrell, Corrine Hanson, Danae Dinkel

Journal Articles

Background

Early breastfeeding cessation is a societal concern given its importance to the health of mother and child. More effective interventions are needed to increase breastfeeding duration. Prior to developing such interventions more research is needed to examine breastfeeding supports and barriers from the perspective of breastfeeding stakeholders. One such framework that can be utilized is the Socio-Ecological Model which stems from Urie Broffenbrenner’s early theoretical frameworks (1973–1979). The purpose of this study was to examine supports and barriers to breastfeeding across environmental systems.

Methods

A total of 49 representatives participated in a telephone interview in Nebraska, USA in 2019. …

The Use Of Family Engagement Principles By Childcare Providers From Various Childcare Settings: A Qualitative Study, John Rech, Kailey Snyder, Maggie Rasmussen, Dipti A. Dev, Danae Dinkel

Journal Articles

Family engagement in childcare is important to ensure the optimal growth, development, and safety of children. Previous research has explored family engagement practices, but limited research is available on the application of theory to explain the uptake of family engagement principles. The purpose of this study was to explore the use and perceptions of the National Association of the Education for Young Children’s six principles of effective family engagement among childcare providers from various childcare settings following the Innovation-Decision Process of the Diffusion of Innovation Theory. A semi-structured interview with a card-sorting task was used to explore providers’ knowledge, adoption, …

A Qualitative Exploration Of The Feasibility Of Incorporating Depression Apps Into Integrated Primary Care Clinics, Danae Dinkel, Jennifer Harsh Caspari, Louis Fok, Maxine Notice, David J. Johnson, Shinobu Watanabe-Galloway, Margaret R. Emerson

Journal Articles

Background: The use of mobile applications or “apps” is beginning to be identified as a potential cost-effective tool for treating depression. While the use of mobile apps for health management appears promising, little is known on how to incorporate these tools into integrated primary care settings – especially from the viewpoints of patients and the clinic personnel. Purpose: The purpose of this study was to explore patient- and clinic-level perceptions of the use of depression self-management apps within an integrated primary care setting. Methods: Patients (n=17), healthcare providers, and staff (n=15) completed focus groups or semi-structured interviews in-person or via …

Gait Variability Is Affected More By Peripheral Artery Disease Than By Vascular Occlusion, Hafizur Rahman, Iraklis Pipinos, Jason M. Johanning, Sara A. Myers

Journal Articles

Background

Patients with peripheral artery disease with intermittent claudication (PAD-IC) have altered gait variability from the first step they take, well before the onset of claudication pain. The mechanisms underlying these gait alterations are poorly understood.

Aims

To determine the effect of reduced blood flow on gait variability by comparing healthy older controls and patients with PAD-IC. We also determined the diagnostic value of gait variability parameters to identify the presence of PAD.

Methods

A cross-sectional cohort design was used. Thirty healthy older controls and thirty patients with PAD-IC walked on a treadmill at their self-selected speed in pain free …

Examining Physical Activity In Users Of Campus Recreation During Campus Closure Due To Covid-19. Journal Of Kinesiology And Wellness, Katie Burcal, Michaela Schenkelberg, Jeanne Surface, Danae Dinkel

Journal Articles

Burcal K., et. al. Campus recreation facilities are a critical resource to encourage physical activity at universities. COVID-19 closures in 2020 led to the shutdown of many campuses, which included campus recreation facilities. Little is known about how the closures impacted the physical activity levels of students, faculty, and staff who relied on campus recreation for physical activity opportunities. Therefore, the purpose of this study was to determine if individuals who were users of campus recreation prior to campus closure continued to be physically active when campus closed. The survey was completed by 282 previous users (students, faculty, and staff) …

Considerations For Implementation Of An Ankle-Foot Orthosis To Improve Mobility In Peripheral Artery Disease, Ayisha Bashir, Danae Dinkel, Ganesh M. Bapat, Holly Despiegelaere, Mahdi Hassan, Jason M. Johanning, Iraklis I. Pipinos, Sara A. Myers

Journal Articles

Objective

To explore the perceptions of wearing an ankle-foot orthosis (AFO) in patients with peripheral artery disease (PAD) who did and did not adopt the AFO intervention. This follows a clinical trial of the effectiveness of an AFO in improving walking distances for patients with PAD-related claudication.

Design

A randomized crossover trial of standard of care and an AFO for 3 months. Semistructured interviews were conducted 1.5 months into the AFO intervention to understand acceptability, demand, implementation, and practicality. Data were analyzed using a summative content analysis approach.

Setting

Vascular surgery clinic and biomechanics research laboratory.

Participants

Patients (N=15; …

Examining Differences In Achievement Of Physical Activity Best Practices Between Urban And Rural Child Care Facilities By Age, Danae Dinkel, John Rech, Yage Guo, Matthew R. Bice, Emily Hulse, Donnia Behrends, Christina Burger, Dipti Dev

Journal Articles

Go Nutrition and Physical activity Self Assessment in Child Care (NAP SACC) is an evidence based intervention developed to positively impact childhood obesity in early childhood education (ECE) facilities. One focus of Go NAP SACC is the development of physical activity best practices. However, little research has examined differences in achievement of best practices based on age of child and geographic location. The purpose of this study was to examine differences in the achievement of physical activity best practices between urban and rural childcare facilities by age-specific recommendations (infants, toddlers, and preschoolers) and in the overall physical activity environment. Urban …

A Cross-Sectional Examination Of Physical Activity, Sedentary Time, And Sleep Between Adults With And Without Children In The Home Using The National Health And Nutrition Examination Survey, Danae Dinkel, Kelsey Lu, Jemima John, Kailey Snyder, Lisette T. Joacobson

Journal Articles

Background: Physical activity (PA), sedentary behavior, and sleep are interconnected, promoting optimal health. Few studies have examined these factors holistically. Therefore, the purpose of this study was to capture the 24-hour activity cycles of the US population by examining PA, sedentary behavior, and sleep based on the presence of a child within the home, as well as gender and weight. Methods: Cross-sectional health-related variables from the National Health and Nutrition Examination Survey were used for analysis. The primary variables were the total and type of PA (recreation, work, and active transportation), sedentary behavior, and sleep. Chi-square and regression …

Mental Health Mobile App Use: Considerations For Serving Underserved Patients In Integrated Primary Care Settings, Margaret R. Emerson, Jennifer Harsh Caspari, Maxine Notice, Shinobu Watanabe-Galloway, Danae Dinkel, Josiane Kabayundo

Journal Articles

Depression, the most commonly experienced mental illness, affects more than 264 million people and is one of the leading causes of disability worldwide [1]. Depression, or major depressive disorder, is characterized by depressed mood and often accompanies other symptoms such as lack of interest, fatigue, feelings of worthlessness, impaired thinking, psychomotor agitation or slowing, thoughts of being better off dead and/or of suicide [2]. According to the 2018 National Survey of Drug Use and Health (NSDUH), 17.7 million or 7.7% of U.S. adults met the criteria for having a major depressive episode in the past year [ …

Perspectives Of Infant Active Play: A Qualitative Comparison Of Working Versus Stay-At-Home Parents, Kailey Snyder, John Rech, Kimberly Masuda, Danae Dinkel

Journal Articles

Background: Parents play a key role in infant’s development through their interactions and the type of environment they provide to promote active play. The amount of time parents are able to spend with their infant is dependent on their working status, yet few studies have explored parent perception of their infant’s active play by working status. The purpose of this study was to explore parent perception of active play and compare responses between working and stay-at-home parents. Methods: Twenty-nine parents participated in this qualitative study by completing a one-time, in-person semistructured interview based on the Theory of Planned Behavior. Themes …

Measuring Freezing Of Gait During Daily-Life: An Open-Source, Wearable Sensors Approach, Martina Mancini, Vrutangkumar V. Shah, Samuel Stuart, Carolin Curtze, Fay B. Horak, Delaram Safarpour, John G. Nutt

Journal Articles

Background

Although a growing number of studies focus on the measurement and detection of freezing of gait (FoG) in laboratory settings, only a few studies have attempted to measure FoG during daily life with body-worn sensors. Here, we presented a novel algorithm to detect FoG in a group of people with Parkinson’s disease (PD) in the laboratory (Study I) and extended the algorithm in a second cohort of people with PD at home during daily life (Study II).

Methods

In Study I, we described of our novel FoG detection algorithm based on five inertial sensors attached to the feet, shins …

Student Perceptions Of A Service-Learning Course In A Rural Setting, Danae Dinkel, Shane Warehime, Julia Zurek, Olivia Welch, Kelsi Leininger, Kaitlyn Mcneil, John Rech, Kyle Ryan

Journal Articles

The primary purpose of this study was to explore students’ perceptions of a servicelearning course at a small, rural, state college. Throughout the semester-long course, the students learned about how to improve afterschool programs and childhood obesity in rural areas similar to the community that encompassed them. The class format consisted of both online discussions over articles, along with in-person meetings. Students then had the option to participate in a paid service opportunity to apply their knowledge in an after-school program; however, no students took part in this component of the class. Reasons the students could not participate in the …