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Articles 361 - 390 of 454
Full-Text Articles in Rehabilitation and Therapy
Muscle Synergy During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Brennan L. Smith
Muscle Synergy During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Brennan L. Smith
Theses and Dissertations--Kinesiology and Health Promotion
INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall …
Grip Force Control Using Prosthetic And Anatomical Limbs, Michael S. Trujillo, Daniel M. Russell, David I. Anderson, Marilyn Mitchell
Grip Force Control Using Prosthetic And Anatomical Limbs, Michael S. Trujillo, Daniel M. Russell, David I. Anderson, Marilyn Mitchell
Rehabilitation Sciences Faculty Publications
Introduction
Skillful object manipulation in various activities of daily living requires accurate and economical modulation of grip force, yet experimental studies investigating grip force using a prosthesis are lacking. The purpose of this study was to compare grip force output between two types of upper-limb prosthetic prehensors. We hypothesized a relationship between grip force output and the muscular tension needed to control the prehensor.
Materials and Methods
Ten able-bodied participants attempted to produce a static target grip force using a voluntary opening and voluntary closing prosthetic simulator and their anatomical hand. The target forces were 0.49 N, 4 N, and …
Student And Faculty Perceptions Of Live Synchronous Distance Education For Allied Health Students Following Program Expansion To A Rural Campus, Betsy J. Becker, Kelsey Rutt, Allyson Huntley, Harlan Sayles, Kim Michael
Student And Faculty Perceptions Of Live Synchronous Distance Education For Allied Health Students Following Program Expansion To A Rural Campus, Betsy J. Becker, Kelsey Rutt, Allyson Huntley, Harlan Sayles, Kim Michael
Internet Journal of Allied Health Sciences and Practice
Background & Purpose: Distance education (DE) is a means to meet allied health workforce needs in rural locations where healthcare worker shortages are apparent. Five allied health programs were expanded to a rural campus teaching synchronously using distance education technology. The purpose of this convergent parallel mixed methods study was to explore perceptions of allied health students and faculty at two campus locations.
Methods: Quantitative and qualitative information were collected through a survey of students and faculty (physical therapy, physician assistant, and medical imaging [diagnostic medical sonography, radiography, magnetic resonance imaging] programs). Both campuses served as live and distance sites …
Virtual Reality As A Training Tool To Treat Physical Inactivity In Children, Adam W. Kiefer, David Pincus, Michael J. Richardson, Gregory D. Myer
Virtual Reality As A Training Tool To Treat Physical Inactivity In Children, Adam W. Kiefer, David Pincus, Michael J. Richardson, Gregory D. Myer
Psychology Faculty Articles and Research
Lack of adequate physical activity in children is an epidemic that can result in obesity and other poor health outcomes across the lifespan. Physical activity interventions focused on motor skill competence continue to be developed, but some interventions, such as neuromuscular training (NMT), may be limited in how early they can be implemented due to dependence on the child’s level of cognitive and perceptual-motor development. Early implementation of motor-rich activities that support motor skill development in children is critical for the development of healthy levels of physical activity that carry through into adulthood. Virtual reality (VR) training may be beneficial …
Cortical Contribution To Linear, Non-Linear And Frequency Components Of Motor Variability Control During Standing, Niklas König Ignasiak
Cortical Contribution To Linear, Non-Linear And Frequency Components Of Motor Variability Control During Standing, Niklas König Ignasiak
Physical Therapy Faculty Articles and Research
Motor variability is an inherent feature of all human movements and reflects the quality of functional task performance. Depending on the requirements of the motor task, the human sensory-motor system is thought to be able to flexibly govern the appropriate level of variability. However, it remains unclear which neurophysiological structures are responsible for the control of motor variability. In this study, we tested the contribution of cortical cognitive resources on the control of motor variability (in this case postural sway) using a dual-task paradigm and furthermore observed potential changes in control strategy by evaluating Ia-afferent integration (H-reflex). Twenty healthy subjects …
Development Of A Concussion Pathway In Acute Care., Katharine Bell Ms, Otr/L, Cbis, Alisha Unternahrer Ms, Otr/L
Development Of A Concussion Pathway In Acute Care., Katharine Bell Ms, Otr/L, Cbis, Alisha Unternahrer Ms, Otr/L
Department of Medicine
No abstract provided.
Orthotic Scar Management For Hands., Lisa Lepage Otr/L
Orthotic Scar Management For Hands., Lisa Lepage Otr/L
Department of Medicine
No abstract provided.
Impacts Of Exercise On Functional Ability Of Recovering Gbs Patients: An Integrative Literature Review, Yasmin Sheriff
Impacts Of Exercise On Functional Ability Of Recovering Gbs Patients: An Integrative Literature Review, Yasmin Sheriff
Grace Peterson Nursing Research Colloquium
This integrative literature review aimed to investigate the impacts exercise has on functional ability of GBS patients in recovery.
Patient Fall Prevention, R9 West Cardiovascular, Cathy Palleschi, Suneela Nayak, Ruth Hanselman, Stephen Tyzik
Patient Fall Prevention, R9 West Cardiovascular, Cathy Palleschi, Suneela Nayak, Ruth Hanselman, Stephen Tyzik
MaineHealth Maine Medical Center
PATIENT FALL PREVENTION STRATEGIES IN AN ACUTE HOSPITAL
Every year in the United States, hundreds of thousands of patients fall resulting in injury. Injured patients often require prolonged hospital stays and a resultant increase in medical costs.
The purpose of this study was to identify the current state of fall prevention strategies on a hospital inpatient acute care cardiac unit. Through a root cause analysis, some deficiencies were identified and a process improvement plan was implemented.
Several positive outcomes were attained as a result of the countermeasures initiated. Patient falls per month and total waste in dollars saw a decline …
Lower Extremity Motor Impairments In Ambulatory Chronic Hemiparetic Stroke: Evidence For Lower Extremity Weakness And Abnormal Muscle And Joint Torque Coupling Patterns, Natalia Sánchez, Ana Maria Acosta, Roberto Lopez-Rosado, Arno H. A. Stienen, Julius P. A. Dewald
Lower Extremity Motor Impairments In Ambulatory Chronic Hemiparetic Stroke: Evidence For Lower Extremity Weakness And Abnormal Muscle And Joint Torque Coupling Patterns, Natalia Sánchez, Ana Maria Acosta, Roberto Lopez-Rosado, Arno H. A. Stienen, Julius P. A. Dewald
Physical Therapy Faculty Articles and Research
Although global movement abnormalities in the lower extremity poststroke have been studied, the expression of specific motor impairments such as weakness and abnormal muscle and joint torque coupling patterns have received less attention. We characterized changes in strength, muscle coactivation and associated joint torque couples in the paretic and nonparetic extremity of 15 participants with chronic poststroke hemiparesis (age 59.6 ± 15.2 years) compared with 8 age-matched controls. Participants performed isometric maximum torques in hip abduction, adduction, flexion and extension, knee flexion and extension, ankle dorsi- and plantarflexion and submaximal torques in hip extension and ankle plantarflexion. Surface electromyograms (EMGs) …
Endothelial Function Is Associated With White Matter Microstructure And Executive Function In Older Adults, Nathan F. Johnson, Brian T. Gold, Christopher A. Brown, Emily F. Anggelis, Alison L. Bailey, Jody L. Clasey, David K. Powell
Endothelial Function Is Associated With White Matter Microstructure And Executive Function In Older Adults, Nathan F. Johnson, Brian T. Gold, Christopher A. Brown, Emily F. Anggelis, Alison L. Bailey, Jody L. Clasey, David K. Powell
Physical Therapy Faculty Publications
Age-related declines in endothelial function can lead to cognitive decline. However, little is known about the relationships between endothelial function and specific neurocognitive functions. This study explored the relationship between measures of endothelial function (reactive hyperemia index; RHI), white matter (WM) health (fractional anisotropy, FA, and WM hyperintensity volume, WMH), and executive function (Trail Making Test (TMT); Trail B - Trail A). Participants were 36 older adults between the ages of 59 and 69 (mean age = 63.89 years, SD = 2.94). WMH volume showed no relationship with RHI or executive function. However, there was a positive relationship between RHI …
Aging With The Fmr1 Gene: A Life Course Perspective, Cornelia Lieb-Lundell
Aging With The Fmr1 Gene: A Life Course Perspective, Cornelia Lieb-Lundell
Physical Therapy Collection
Fragile X syndrome (FXS) is one of three syndromes identified as a health condition related to fragile X mental retardation (FMR1) gene dysfunction. The other two conditions are Fragile X-associated primary ovarian insufficiency syndrome (FXPOI) and Fragile X-associated tremor/ataxia syndrome (FXTAS) which together are referred to as Fragile X-associated disorders (FXD). Even though the three conditions share a common genetic defect each one is a separate health condition that results in a variety of body function impairments such as motor delay, musculoskeletal issues related to low muscle tone, coordination limitations, ataxia, tremor, undefined muscle aches and pains; and, …
Three Faces Of Fragile X Syndrome, Cornelia Lieb-Lundell
Three Faces Of Fragile X Syndrome, Cornelia Lieb-Lundell
Physical Therapy Collection
Fragile X Syndrome (FXS) is well known and widely recognized in pediatrics. Less well known is that FXS, as an X-linked disorder of the FMR1 gene, is but one of three impairments that all have a common single-gene genetic basis. These three are labeled Fragile X-associated Disorders (FXD) and are, in turn, a part of a large group of impairments which have a collective name of trinucleotide repeat expansion disorders. Common to all three FXD disorders is that the x-gene carries a characteristic CGG expansion (of the DNA) that can range from 50-+200 (5-45 is normal) with premutation carriers having …
Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph
Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph
Osteopathic Medicine Student Research Posters
Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …
Neuromuscular Function In Women Postpartum, Rita Deering
Neuromuscular Function In Women Postpartum, Rita Deering
Dissertations (1934 -)
Efficient abdominal muscle function is important for functional mobility in men and women, and dysfunction of these muscles has been associated with impaired function such as low back pain. This dissertation explored abdominal muscle function in healthy young men and young women who have never been pregnant (nulligravid). As pregnancy and child birth also impact the tissues of the abdominal wall, this dissertation will also explore abdominal muscle function in postpartum women. This dissertation involved three primary aims. Aim1 compared abdominal muscle function and experimental pain perception in males and nulligravid females. Maximal strength over a range of trunk angles, …
The Effects Of Early Mobilization On Length Of Stay For Patients Undergoing Total Joint Replacement Surgery., Megan Howard Pt, Mpt, Kimberly Fritts Pt, Mpt
The Effects Of Early Mobilization On Length Of Stay For Patients Undergoing Total Joint Replacement Surgery., Megan Howard Pt, Mpt, Kimberly Fritts Pt, Mpt
Department of Medicine
No abstract provided.
The Motor Cortical Representation Of A Muscle Is Not Homogeneous In Brain Connectivity, Jo Armour Smith, Alaa Albishi, Sarine Babikian, Skulpan Asavasopon, Beth E. Fisher, Jason Kutch
The Motor Cortical Representation Of A Muscle Is Not Homogeneous In Brain Connectivity, Jo Armour Smith, Alaa Albishi, Sarine Babikian, Skulpan Asavasopon, Beth E. Fisher, Jason Kutch
Physical Therapy Faculty Articles and Research
Functional connectivity patterns of the motor cortical representational area of single muscles have not been extensively mapped in humans, particularly for the axial musculature. Functional connectivity may provide a neural substrate for adaptation of muscle activity in axial muscles that have both voluntary and postural functions. The purpose of this study was to combine brain stimulation and neuroimaging to both map the cortical representation of the external oblique (EO) in primary motor cortex (M1) and supplementary motor area (SMA), and to establish the resting-state functional connectivity associated with this representation. Motor evoked potentials were elicited from the EO muscle in …
The Intra-Rater Reliability Of The Clavicular Jump Test (Cjt), Thomas Koc
The Intra-Rater Reliability Of The Clavicular Jump Test (Cjt), Thomas Koc
Seton Hall University Dissertations and Theses (ETDs)
Background: Shoulder pain is the third most common musculoskeletal complaint in today’s society. Approximately 50% of patients with shoulder pain seek medical attention, which includes physical therapy. A thorough understanding of the anatomy of the shoulder, including its fascial attachments, its biomechanics, and functional relationship to nearby spinal regions is crucial for successful rehabilitation diagnostics and treatment interventions. Purpose: The purpose of this study is to determine the intra-rater reliability of the Clavicular Jump Test (CJT). Methods: This study is a quasi-experimental, one-group pretest-posttest (repeated measures), and correlation design. A total of 96 subjects (47 males and 49 females) volunteered …
Efficacy Of Electromyography And The Dead Bug Exercise, Taylor M. Scavo, Rachel C. Cooklin, Erika N. Faria, Madeline L. Johnson, Eric Sternlicht
Efficacy Of Electromyography And The Dead Bug Exercise, Taylor M. Scavo, Rachel C. Cooklin, Erika N. Faria, Madeline L. Johnson, Eric Sternlicht
Student Scholar Symposium Abstracts and Posters
The Dead Bug exercise is performed in physical therapy clinics to restore lumbar spine stability and core strength in patients with lower back pain (LBP). The aim of this study was to evaluate the efficacy of using electromyography (EMG) feedback to enhance proper mechanics during the Dead Bug exercise. Sixteen healthy, college age students volunteered as subjects for the study. Subjects performed the Dead Bug (Fig. 1a.) with and without visual EMG cues and were given instructions on how to execute the exercise. Data was recorded using a BTS FREEEMG Analyzer and signal processed and data analyzed using the BTS …
Trunk And Respiratory Motor Control In Typically Developing Children And Its Implications In Children With Chronic Spinal Cord Injury., Goutam Singh
Electronic Theses and Dissertations
Independent sitting is a major milestone and is also a prerequisite for optimal performance of activities of daily living (ADLs). Development of sitting posture control is a dynamic process involving control of degrees of freedom of head and trunk. Traditionally, trunk has been modeled as a single unit (segment). However, recent studies have suggested that it is made up multiple spinal units, controlled by a combination of trunk muscles. During typical development, posture control of trunk is different for different trunk segments. This motor development of trunk control is a complex process due to constant interaction between the nervous system …
The Immediate Cardiovascular Response To Joint Mobilization Of The Neck - A Randomized, Placebo-Controlled Trial In Pain-Free Adults, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, David A. Cameron
The Immediate Cardiovascular Response To Joint Mobilization Of The Neck - A Randomized, Placebo-Controlled Trial In Pain-Free Adults, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, David A. Cameron
All PTHMS Faculty Publications
Background: Some normotensive patients can have a spike in resting systolic blood pressure (SBP) in response to acute neck pain. Applying the typical dosage of mobilization may potentially result in a sympatho-excitatory response, further increasing resting SBP. Therefore, there is a need to explore other dosage regimens that could result in a decrease in SBP.
Objectives: To compare the blood pressure (BP) and heart rate (HR) response of pain-free, normotensive adults when receiving unilateral posterior-to-anterior mobilization (PA) applied to the neck versus its corresponding placebo (PA-P).
Study design: Double-Blind, Randomized Clinical Trial.
Sex-Dependent Effects Of Ho-1 Deletion From Adipocytes In Mice, Peter A. Hosick, Mary Frances Weeks, Michael W. Hankins, Kyle H. Moore, David E. Stec
Sex-Dependent Effects Of Ho-1 Deletion From Adipocytes In Mice, Peter A. Hosick, Mary Frances Weeks, Michael W. Hankins, Kyle H. Moore, David E. Stec
Department of Exercise Science and Physical Education Scholarship and Creative Works
Induction of heme oxygenase-1 (HO-1) has been demonstrated to decrease body weight and improve insulin sensitivity in several models of obesity in rodents. To further study the role of HO-1 in adipose tissue, we created an adipose-specific HO-1 knockout mouse model. Male and female mice were fed either a control or a high-fat diet for 30 weeks. Body weights were measured weekly and body composition, fasting blood glucose and insulin levels were determined every six weeks. Adipocyte-specific knockout of HO-1 had no significant effect on body weight in mice fed a high-fat diet but increased body weight in female mice …
Role Of Corpus Callosum Integrity In Arm Function Differs Based On Motor Severity After Stroke, Jill Campbell Stewart, Pritha Dewanjee, George Tran, Erin Burke Quinlan, Lucy Dodakian, Alison Mckenzie, Jill See, Steven C. Cramer
Role Of Corpus Callosum Integrity In Arm Function Differs Based On Motor Severity After Stroke, Jill Campbell Stewart, Pritha Dewanjee, George Tran, Erin Burke Quinlan, Lucy Dodakian, Alison Mckenzie, Jill See, Steven C. Cramer
Physical Therapy Faculty Articles and Research
While the corpus callosum (CC) is important to normal sensorimotor function, its role in motor function after stroke is less well understood. This study examined the relationship between structural integrity of the motor and sensory sections of the CC, as reflected by fractional anisotropy (FA), and motor function in individuals with a range of motor impairment level due to stroke. Fifty-five individuals with chronic stroke (Fugl-Meyer motor score range 14 to 61) and 18 healthy controls underwent diffusion tensor imaging and a set of motor behavior tests. Mean FA from the motor and sensory regions of the CC and from …
What Is The Contribution Of Ia-Afference For Regulating Motor Output Variability During Standing?, Niklas König Ignasiak
What Is The Contribution Of Ia-Afference For Regulating Motor Output Variability During Standing?, Niklas König Ignasiak
Physical Therapy Faculty Articles and Research
Motor variability is an inherent feature of all human movements, and describes the system‘s stability and rigidity during the performance of functional motor tasks such as balancing. In order to ensure successful task execution, the nervous system is thought to be able to flexibly select the appropriate level of variability. However, it remains unknown which neurophysiological pathways are utilized for the control of motor output variability. In responding to natural variability (in this example sway), it is plausible that the neuro-physiological response to muscular elongation contributes to restoring a balanced upright posture. In this study, the postural sway of 18 …
Osteoblast-Derived Fgf9 Regulates Skeletal Homeostasis, Liping Wang, Theresa M. Roth, Marcia J. Abbott, Linh Ho, Lalita Wattanachanya, Robert A. Nissenson
Osteoblast-Derived Fgf9 Regulates Skeletal Homeostasis, Liping Wang, Theresa M. Roth, Marcia J. Abbott, Linh Ho, Lalita Wattanachanya, Robert A. Nissenson
Health Sciences and Kinesiology Faculty Articles
FGF9 has complex and important roles in skeletal development and repair. We have previously observed that Fgf9 expression in osteoblasts (OBs) is regulated by G protein signaling and therefore the present study was done to determine whether OB-derived FGF9 was important in skeletal homeostasis. To directly test this idea, we deleted functional expression of Fgf9 gene in OBs using a 2.3 kb collagen type I promoter-driven Cre transgenic mouse line (Fgf9OB −/−). Both Fgf9 knockout (Fgf9OB −/−) and the Fgf9 floxed littermates (Fgf9fl/fl) mice were fully backcrossed and maintained in an FBV/N background. Three …
The Assessment Of Medial Stability Of The Elbow Using Sonography And Three Clinical Tests, Andrew Michael Demoss
The Assessment Of Medial Stability Of The Elbow Using Sonography And Three Clinical Tests, Andrew Michael Demoss
Theses, Dissertations and Capstones
Introduction: Injuries to the Ulnar Collateral Ligament of the elbow are a common occurrence in overhead throwing athletes. Clinical assessment of the medial elbow can be assisted using Sonography. Ultrasound imaging can be used to determine the width of the medial joint space. This study will determine whether altering the joint angle in the elbow during various clinical tests has an effect on the width of the medial joint space.
Methods: Ultrasound images of the non-dominant elbow were collected during three clinical tests of medial elbow stability; valgus stress test, weighted valgus test and the milking maneuver. The …
The Reliability Of The Navicular Drop Test And Its Transferability To Dynamic Movement, Joshua Krispin
The Reliability Of The Navicular Drop Test And Its Transferability To Dynamic Movement, Joshua Krispin
College of Graduate Studies: Theses & Dissertations
Background: Navicular drop can be defined as the distance the navicular tuberosity moves from a standing weight bearing to a standing neutral position, as the subtalar joint moves from a relaxed position to a neutral position. Navicular drop is an important measurement for clinicians used to describe foot function, pronation, and excessive movement seen in several pathologies. Objective: The purpose of this study is to see if navicular drop is influenced by mode or speed of locomotion, if it is will there be other influences such as the forefoot and heel soft tissue, and will those factors influence those measures. …
Somatosensory Deficits In Post-Acl Reconstruction Patients: A Case-Control Study, Johanna M. Hoch, William O. Perkins, Jonathan R. Hartman, Matthew C. Hoch
Somatosensory Deficits In Post-Acl Reconstruction Patients: A Case-Control Study, Johanna M. Hoch, William O. Perkins, Jonathan R. Hartman, Matthew C. Hoch
Rehabilitation Sciences Faculty Publications
Introduction: Diminished cutaneous detection thresholds have been identified in patients with multiple orthopedic conditions, and these phenomena may occur in postanterior cruciate ligament reconstructed (ACLR) patients. The purpose of this study was to determine if differences in lower extremity cutaneous detection thresholds exist in post-ACLR patients when compared with healthy controls. Methods: Fifteen individuals who were post-ACLR and 15 individuals who had no history of knee injury participated. Light touch cutaneous detection thresholds were assessed at 4 locations on the foot and ankle (first metatarsal, fifth metatarsal, medial malleolus, and lateral malleolus). Nonparametric statistics examined group differences between the …
Perceptual Variations In Thermoregulation During Exercise In A Hot Environment, William C. Alger
Perceptual Variations In Thermoregulation During Exercise In A Hot Environment, William C. Alger
Electronic Theses and Dissertations
ABSTRACT
Professionals are seeking to find ways to prevent exertional heat illness (EHI) in populations working in hot environments as well as populations that are physically active. The purpose of the present study was to evaluate individuals’ ability to accurately perceive core temperature ranges associated with homeothermic and EHI temperatures during exercise. Ten physically active males exercised on a treadmill at a self-selected rate until core temperature reached 39°C. Participants rated perceived core and skin temperature on 100 mm scales each time core temperature increased 0.25˚ C (37.5-39.0˚ C), along with thermal comfort and sweating sensation. During exercise core temperature …
Evaluating Cardiovascular Dysfunction During Increased Activity And Exercise Rehabilitation Following Incomplete Thoracic Spinal Cord Injury In The Adult Rat., Kathryn A. Harman
Evaluating Cardiovascular Dysfunction During Increased Activity And Exercise Rehabilitation Following Incomplete Thoracic Spinal Cord Injury In The Adult Rat., Kathryn A. Harman
Electronic Theses and Dissertations
Spinal cord injury (SCI) results in whole-body dysfunction. While the majority of SCI research is focused on improving locomotor function after injury, cardiovascular (CV) disease continues to be the leading cause of morbidity in the chronic SCI patient population. The combination of injury-induced destruction of autonomic pathways, maladaptive plasticity within lumbosacral circuits, and the progressive decline in physical fitness contribute to the poor CV status of SCI individuals. Currently, there is little emphasis on implementing appropriately-timed acute rehabilitation techniques aimed to curtail maladaptive remodeling and improve CV outcomes. Furthermore, no pre-clinical or clinical studies have investigated the most appropriate time-course …