Physical Therapy Commons^™

Efficacy Of Curl Up Task As Abdominal Exercise Program For Diastasis Recti Abdominis, Wendy Chorny, Betsy K. Donahoe-Fillmore, Rio Harrelson, Laney Hulbert, Jessica Westerfield, Mary I. Fisher

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/Hypothesis: The separation between the rectus abdominal muscles caused by a widening and thinning linea alba, called diastasis recti abdominis (DRA), contributes to impairments in strength of the abdominal and trunk muscles. DRA is most frequently observed during pregnancy and may recede after childbirth but can be present at 12 months or later after giving birth. The purpose of this study was to determine if a focused 12 or 24 week exercise program improves inter-rectus distance and abdominal strength in women who have given birth.

Number of Subjects: Forty-eight women 27-49 years (mean 37 years) were randomized into a 12 …

Determining The Concurrent And Predictive Validity Of The Repetitive Step Test In Individuals With Parkinson's Disease, Rachel Wells, Evan Callahan, Jacob Greco, Harold L. Merriman, Kurt Jackson

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/Hypothesis: The Repetitive Step Test (RST) assesses rapid stepping capability in anterior lateral (AL) and posterior lateral (PL) diagonal directions. This study’s goal was to determine the predictive validity of the RST to identify fallers with Parkinson’s Disease (PD). A secondary objective was to determine concurrent validity of the RST to other established tests. It was hypothesized that those who completed fewer steps with the RST would be more likely to fall and that the RST would predict falls at least as well as the other balance tests.

Materials and Methods: 13 subjects (8 F, 5 M; mean age 70.2 …

Ehealth Cancer-Related Fatigue Intervention Single Arm Study, Anne Fleischer, Samantha Gelhaus, Emily Flohre, Caroline Frazee, Mary I. Fisher, Carrie Pickering

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/Hypothesis: Cancer related fatigue (CRF), a sense of physical, emotional and cognitive tiredness not relieved by rest, negatively affects function. Prevalence is reported to be 59-100% throughout the care continuum. Exercise and psychosocial interventions are supported as effective treatment options, yet barriers to personalized care include time and distance to travel for care. The purpose of this pilot study was to evaluate the effectiveness of personalized exercise prescribed by physical therapy (PT), and occupational goal setting and tasks prescribed by occupational therapy (OT) on physical function.

Number of Subjects: 16 adults with cancer and fatigue ≥4/10.

Materials and Methods: Over …

Altering The Lower Limb Kinetic Chain: Reliability And Minimum Detectable Change Of Total Support Moment, J Barrios, R Cloud, M Gorski, A Grieshop, A Kinney

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose: 3D joint kinetics are routinely studied in various lower limb musculoskeletal conditions. Often, a condition affecting a joint is associated with altered kinetics at that same joint, such as knee osteoarthritis being associated with reduced knee flexion moments. However, these same-joint alterations may also contribute to altered comprehensive movement patterns of the entire limb in a synergistic manner. A lower limb biomechanical metric that represents this multi-joint kinetic chain synergy is the total support moment (TSM). Indeed, TSM has been found to be altered in knee osteoarthritis, anterior cruciate ligament reconstruction, and partial meniscectomy. Despite this, psychometric studies are …

The Relationship Between Economic Status And Patient Retention In The Physical Therapy Setting In Selected Physical Therapy Clinics And Hospitals Of Negros Oriental: Perspective Of Filipino Physical Therapists, Rey Joshua P. Osorio, Zoscheele Monica G. Pal, Clarice M. Planteras, Raymon D. Ragay, Ginea Marydawn N. Roda, Rapunzel G. Santillan, Niña Mae B. Sequita, Ulrich Tristan Weber

Student Dissertations

Patient retention has always been part of the goals in the medical field, especially in the Physical Therapy setting; there were some studies that depicted a contingent effect on its likelihood with the patients’ economic status. However, the lack of evidence-based studies in PT surrounding these variables have made it difficult to pinpoint the relationship between the two. This study investigated how economic status influences patient retention in physical therapy settings in Negros Oriental, Philippines. It combined quantitative data from surveys on participant demographics, economic status, and patient retention with qualitative insights gathered through semi-structured interviews. The data collected suggested …

Wrist Flexor And Extensor Tendon Stiffness During Functional Grip: A Pilot Study, Kristin Stein, Matthew Stephens, Camryn Yacks, Harold Merriman, Joseph Day

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/Hypothesis: Ultrasound shear wave elastography (SWE) quantifies muscle stiffness, a mechanical muscle property that is known to influence muscle function. Gripping is an important functional task and relies on the synergistic actions of the wrist flexors and extensors. To date, there are no studies to quantify tendon stiffness as measured by SWE during a functional task like gripping. The purpose of this study was to quantify differences between resting and submaximal gripping stiffness of the common wrist flexor (CFT) and common wrist extensor tendons (CET). Secondly, we aimed to compare tendon stiffness values between the flexor tendon and extensor tendons …

Effectiveness Of A Talocrural Joint Mobilization On Restricted Dorsiflexion: A Time Series Intervention Analysis, Carly Archambeau, Ceili Kacmarcik, Camryn Yacks

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/Hypothesis: Restricted ankle dorsiflexion (DF) mobility is a common musculoskeletal impairment. For intervention, ankle joint mobilizations are often utilized to address restricted DF. Interestingly, no studies have investigated the short-term effect duration of a joint mobilization intervention on restricted DF. Therefore, the purpose of this study was to observe the initial effectiveness and effect duration of a DF mobilization treatment. DF measures included both a static inclinometer-based weight-bearing lunge test (WBLT) as well as dynamic 3D motion capture-based peak ankle DF during a forward step down (FSD) task. We hypothesized that both measures would increase post-mobilization and fade to baseline …

The Use And Accuracy Of Millimeter Wave Radar And Machine Learning For Gait Classification And Monitoring, Mubarak Alanazi, Abdullah Alhazmi, Vamsy Chodavarapu, Kurt Jackson, Meghan Brown, Kara Gnau, Shannon Thiel

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/hypothesis: The ability to monitor human activity remotely may be useful in providing telerehabilitation and measuring real-world rehabilitation outcomes. Current methods of activity monitoring have significant limitations (cost, privacy, ease of use) that can limit their benefit and widespread use. Recent advances in machine learning (ML) and millimeter wave radar (MWR) have allowed for the development of a cost effective and simple way to monitor human movement continuously and remotely while maintaining reasonable privacy. The purpose of this study was to test the ability of ML and MWR to accurately classify and monitor different types of human activity including different …

An Artificial Intelligent Millimeter Wave Radar System For Human Activity Recognition And Monitoring, Abdullah Alhazmi, Vamsy Chodavarapu, Kurt Jackson, Cameron Djukic, Jennifer Jaszek, Anna Brown

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/hypothesis: The ability to monitor human activity remotely may be useful in providing telerehabilitation and measuring real-world rehabilitation outcomes. Current methods of activity monitoring have significant limitations (cost, privacy, ease of use) that can limit their benefit and widespread use. Recent advances in machine learning (ML) and millimeter wave radar (MWR) have allowed for the development of a cost effective and simple way to monitor human movement continuously and remotely while maintaining reasonable privacy. The purpose of this study was to test the ability of ML and MWR to accurately classify and monitor different types of human activity including falls. …

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …

The Impact Of Anatomy Academy In Underserved Las Vegas Elementary Schools, Jean Angeles, Edgar Armengual, Katrina Myers, Perceval Vollmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anatomy Academy is an interactive, service-learning experience that allows doctoral physical therapy students to pose as educators for elementary-aged adolescents. Through instructional and activity-based learning, mentors formulated the program to encase anatomical, physiological, nutritional, and general health and wellness topics that translate into overall healthy behaviors. The experiment enveloped 7 major sectors of anatomy, including the musculoskeletal system, cardiovascular system, pulmonary system, oral cavity/nutrition, gastrointestinal system, sensory system, and central nervous system. Throughout the length of the program, the doctoral candidates reviewed the quality of the content delivered, the engagement of the students and staff, and the effects this had …

Modulating Cortical Excitability To Improve Functional Movements In Individuals With Patellofemoral Pain: A Randomized Controlled Trial, Jeno Aquino, Bryce Broadwell, Connan Wallace, Makenzie Whimple

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Persons with patellofemoral pain (PFP) often exhibit increased knee valgus during functional tasks that is traditionally addressed by strengthening weak hip musculature. However, research related to this topic has revealed altered cortical reorganization in individuals with PFP contributes to dysfunctional movements and underscores the critical role of central neural control in this condition. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that alters cortical excitability to enhance neuroplasticity. Research using tDCS priming supports its feasibility as a possible treatment for other musculoskeletal conditions. However, its application specifically targeting the corticomotor function of the gluteal musculature in individuals with …

Effects Of Chronic Diabetes And Attentional Focus On Performance And Learning Of A Novel Stabilometer Balance Task, Rebeca Carolina Armagnac Gonzalez, Yinny H. Lee, Alicia Marie Letkiewicz, Meiko Nagano Mamauag

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Chronic diabetes is a prevalent systemic disease that impairs physical functioning and often leads to increased risk of falls. Adopting an external focus of attention during motor skill practice has been shown to improve learning outcomes, however, it has not been examined in this population. We examined how attentional focus instructions (internal vs. external) affect balance performance and learning in older adults with and without diabetes.

Methods: Fifty-three older adults (27 with diabetes, 63.7±7.0 years) participated in the randomized, pre-post intervention study. The balance training involved 50 practice trials of a stabilometer task that was novel to …

Implementing Physical Therapy Services And Screenings For The Students Of The Unlv College Of Fine Arts For Health And Injury Prevention: A Service-Learning Approach, Selene Barajas, Justin Dietrich, Brenna Ganzon, Payton Mack, Katherine Metzger, Tanner Mueller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals who participate in Fine Arts such as orchestra, dance, and theater at high levels are predisposed to injury. Many of these injuries are preventable, and when not adequately managed, they can result in lost rehearsal time and prevent participation in performances required for degree completion. While collegiate athletes typically have access to healthcare resources such as a team physician, athletic trainer, and physical therapist, collegiate performing artists often must navigate the healthcare environment on their own. Furthermore, available healthcare providers may lack knowledge and experience working with performing artists and be less able to treat the unique healthcare needs …

Effect Of Asynchronous Virtual Interviews On Ethnic Minority Matriculation Into A Doctor Of Physical Therapy Program, Conner Clark, Nanea Lagasca, Gladys Miller, Jasmine Puspos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: This study examines the impact of the use of asynchronous virtual interviews (AVIs) in the admissions process of the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). This research aims to examine racial and ethnic subgroup differences in AVI scores, evaluate the influence of AVIs on applicant scores in the admissions process, and assess the AVI inter-rater reliability among faculty evaluators using data from the 2019-2022 admissions cycles.

Results: Significant differences were found in AVI scores among racial and ethnic groups, with Black applicants scoring highest and Asian applicants scoring lowest. Additionally, inclusion …

Effects Of Exercise On Level Of Support, Mobility, And Quality Of Life In Adults With Down Syndrome, Jorge Lorza-Lopez, Jolena Sagaya, Simone Schroder, Paige Melvin Zink

UNLV Theses, Dissertations, Professional Papers, and Capstones

Down syndrome (Ds) is a genetic disorder characterized by the autosomal abnormality of a third copy of chromosome 21. Due to the physical and intellectual disabilities that many people with Ds experience, they often need support with (instrumental) activities of daily living. Since adults with Ds are living longer, it is important to determine how exercise can affect mobility and quality of life in the Ds community. The impact on more functional outcomes, such as level of support and quality of life has not been systematically investigated. Therefore, the aim was to investigate whether twelve weeks of a remote, structured …

Relation Between Cognitive Assessment And Clinical Physical Performance Measures After Mild Traumatic Brain Injury, Prokopios Antonellis, Margaret M. Weightman, Peter C. Fino, Siting Chen, Mark E. Lester, Carrie W. Hoppes, Leland E. Dibble, Laurie A. King

Physical Therapy Faculty Publications

Objectives

To investigate the relation between cognitive and motor performance in individuals with mild traumatic brain injury(mTBI) and examine differences in both cognitive and motor performance between adults after mTBI and healthy controls.

Design

Multi-center, cross-sectional study.

Setting

Three institutional sites (Courage Kenny Research Center, Minneapolis, MN, Oregon Health & Science University, Portland, OR, and University of Utah, Salt Lake City, UT).

Participants

Data were collected from 110 participants (N=110), including those with mTBI and healthy controls, who completed cognitive and physical performance assessments.

Interventions

Not applicable.

Outcome Measures

Cognitive assessments involved the Automated Neuropsychological Assessment Metrics to evaluate …

North Dakota Physical Therapy Workforce And Telehealth Utilization Between 2018-2022, Nicole A. Thomas, Elise J. Bartel, Logan Thomas, Senior, Brendan E. Kalous, Hunter T. Sylte

Physical Therapy Scholarly Projects

Physical Therapists (PT’s) are important healthcare providers for individuals of all ages, ailments, and provide both prevention and care of disease and injury. Traditionally, physical therapists work in a wide variety of settings including hospitals, nursing homes, schools, sports/outpatient clinics, and privately-owned clinics, to name a few. There are approximately 7.2 physical therapists for every 10,000 people nationwide. However, the geographical distribution and practice settings of PT’s can greatly vary throughout each state, county, and region. This varying distribution of PT’s creates one of the biggest limitations surrounding the field of PT which is decreased access to physical therapy services …

Reverse Total Shoulder Arthroplasty And The Effects Of Physical Therapy In The Outpatient Setting: A Case Report, Troy L. Huff

Physical Therapy Scholarly Projects

Introduction: Reverse total shoulder arthroplasty (RTSA)is gaining popularity globally for treatment of traumatic and degenerative glenohumeral diseases, as well as for irreparable rotator cuff total shoulder arthroplasty surgeries. The number of these surgeries in 2011 were 22,820 and have jumped to a staggering increase of more than 60,000 a year in 2023. The goal of this case study is to determine the role and effectiveness of physical therapy in a status post RTSA.

Case Description: The patient was a 70-year-old year male who had a right RTSA. The patient had comorbidities of Osteoarthritis of the right shoulder, a failed …

Functional Movement Screen: Exploring Interrater Reliability Between Students, Katie Biegel, Maari Dolan, Sidni Kast, Abi Kuznia, Blake Sjostrom

Physical Therapy Scholarly Projects

Purpose/Hypothesis: The purpose of this study was to assess the interrater reliability between five second-year physical therapy students on the scoring of the Functional Movement Screen (FMS) on 45 participants via pre-recorded videos. To our knowledge, few studies have been completed regarding interrater reliability on the FMS with the new criteria on the ankle mobility clearing test and updated criteria on the rotary stability test.

Materials/Methods: The students and an FMS expert reviewed grading criteria for each test and clearing test. Each student rater was allowed to watch each video once to score the motion to the best of …

The Effects Of Palm Cooling On Power, Strength, And Endurance: An Investigative Study, Klye Henningsgard, Riley Mattheis, Shawn Stolz

Physical Therapy Scholarly Projects

Modern day athletes are continuously searching for ways that they can find a competitive advantage over their peers. This study aimed to assess if palm cooling was effective in increasing power, strength, and/or endurance during exercise. After completing a warmup, 24 participants (11 males,13 females; age 22.75 ± 1.36) were assessed on two separate occasions where they performed three separate exercises: vertical jump to analyze power, isometric knee extension to analyze strength, and Queen’s College Step Test to analyze endurance. On the first day of testing, participants were randomly assigned into a cooling or non-cooling group. Thus, completing all three …

Inpatient Physical Therapy Management Of A Patient Sustaining Multiple Fractures And A Hemorrhagic Temporal Lobe Contusion Due To An Absent Seizure And Fall: A Case Report, Kylie M. Helgeland

Physical Therapy Scholarly Projects

Introduction: A case report for the acute care assessment and treatment of a patient after a seizure and fall that resulted in multiple fractures and a temporal lobe contusion. Every injury has an impact on a patient’s mobility and their ability to perform activities of daily living. Physical therapists need to see each injury and understand how each one can affect the patient and have a barrier on their recovery.

Case description: A 59-year-old female who fell down 3 stairs during an absent seizure resulting in multiple fractures and a temporal contusion. The patient presented with impairments of motor planning, …

The Effect Of Physical Therapy Intervention On Fatigue, Balance, Depression And Quality Of Life In Clients Following Medical Treatment For Cancer: A Pilot Study, Elle G. Bryant, Morghan J. Bugge, Riley A. Grube, Megan M. Lacrosse, Hunter M. Lake, Katie J. Leary

Physical Therapy Scholarly Projects

Approximately 18.1 million people living in the United States have survived cancer. The treatment for cancer can be accompanied by many long-lasting residual side effects including fatigue, decreased quality of life, balance deficits, and depression. A current problem that healthcare providers face is understanding these side effects and how to effectively treat the people who experience them.

The purpose of this pilot study is to investigate how cancer treatments affect the human body, specifically with fatigue, balance, quality of life, and depression, and how physical therapy interventions can be used to combat these factors. To assess the effects of physical …

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

The Effects Of Implementing An Early Childhood Education Health And Wellness Program In Underserved Elementary Schools In Las Vegas On Student Mentors And Elementary Staff: Anatomy Academy, Alexa Blazek, Amber Berumen Baker, Kevin Chan Shum, Alexander Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Academy (AA) is a seven/eight-week program implemented by select University of Nevada, Las Vegas Doctorate of Physical Therapy (DPT) students to promote health and wellness at a Title I elementary school and help bridge the health education gap that underserved youth populations may be facing. We aimed to assess and improve the overall satisfaction of both the faculty members at the elementary school and the physical therapy students who participated in the program, while enhancing the health education of 5th grade students. Our aim was centered on stakeholders (elementary school administrators) and student mentors (DPT students) having the desire to …

Implementation Of An Evidence-Based Program To Reduce Fall Risk Of Older Adults In Nevada, Hanna Brunty, Jordynn Cowan, Taylor Derose, Kanosha Gray, Kerry Margolin

UNLV Theses, Dissertations, Professional Papers, and Capstones

As Doctor of Physical Therapy (DPT) students from the University of Nevada, Las Vegas, we completed a service-learning project to deliver a free evidence-based fall prevention program to senior residents of Nevada. “Stepping On” is a 7-week fall prevention program from the Wisconsin Institute for Healthy Aging that is designed for older adults who are at risk or fearful of falling or for those who want to increase their awareness of fall prevention strategies. The program includes learning balance and strengthening exercises, discussing fall prevention strategies, and collaborating with community partners and healthcare professionals. The first objective of this service-learning …

Better Gait Quality And Speed In Adults With Down Syndrome When Wearing Supportive Shoes Compared To Unsupportive Shoes And Barefoot, Bailey Gosse, Kimberly Nguyen, Zoe Zelensky

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals with Down syndrome (DS), often experience a slower gait speed and decreased quality of gait. Different types of footwear have shown changes in gait in people without DS. The current study aimed to examine the differences between wearing commercially available supportive shoes, unsupportive shoes, and no footwear on gait quality and speed in people with DS.

Methods: In this repeated measures study, 20 adults with DS walked under three footwear conditions: supportive, unsupportive, and no footwear. Gait deviations were scored according to the Rancho Los Amigos Observational Gait Analysis (OGA) and gait speed was measured using the 10-Meter …

Development And Pilot Testing Of A Surface Discrimination Test For People With Lower Limb Amputation, Colin Kruger, Kyle Mcknight, Sharlene Lim, Samuel Straus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: There is a lack of understanding as to how sensory loss and sensory deficits impact those with LLA. The purpose of this research is to determine the extent to which people with LLA can discriminate between surfaces underfoot, in order to better understand the relationship between people with LLA and their perception of the ground they are walking on. We developed a test to determine which qualities of surfaces may be easier to distinguish.

Methods: 10 unimpaired adults and 2 adults with LLA participated. Participants compared surfaces underfoot that consisted of ceramic, rough tile, gravel, sand, and sandpaper to …

Alteration In Resting-State Brain Activity In Stroke Survivors After Repetitive Finger Stimulation, Dorothy He, William A Sikora, Shirley A James, Jordan N Williamson, Louis V Lepak, Carolyn F Cheema, Evgeny Sidorov, Sheng Li, Yuan Yang

Faculty, Staff and Student Publications

Objective: This quasi-experimental study examined the effect of repetitive finger stimulation on brain activation in eight stroke and seven control subjects, measured by quantitative electroencephalogram.

Methods: We applied 5 mins of 2-Hz repetitive bilateral index finger transcutaneous electrical nerve stimulation and compared differences pre- and post-transcutaneous electrical nerve stimulation using quantitative electroencephalogram metrics delta/alpha ratio and delta-theta/alpha-beta ratio.

Results: Between-group differences before and after stimulation were significantly different in the delta/alpha ratio ( z = -2.88, P = 0.0040) and the delta-theta/alpha-beta ratio variables ( z = -3.90 with P < 0.0001). Significant decrease in the delta/alpha ratio and delta-theta/alpha-beta ratio variables after the transcutaneous electrical nerve stimulation was detected only in the stroke group (delta/alpha ratio diff = 3.87, P = 0.0211) (delta-theta/alpha-beta ratio diff = 1.19, P = 0.0074).

Conclusions: The decrease in quantitative electroencephalogram metrics in the stroke …

Introduction Of The Anatomy Academy Program To Children In A Rural Elementary School, Rox Aurelio, Madison Dobbs, Nicole Horn, Gianni Terrana

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children in rural communities experience health and education disparities. Early exposure to health promoting habits can positively impact future health habits. Healthcare providers who grew up in rural areas are more likely to practice in rural areas. Doctor of physical therapy students and physical therapists implemented Anatomy Academy, a service-learning program aimed at promoting healthy living and introducing healthcare occupations, to elementary students in a rural area as this program had previously only been implemented in urban areas. The Biomedical Institutional Review Board at the University of Nevada, Las Vegas approved this study. A 40-minute lesson was delivered weekly for …