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Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral 2025 University of Kentucky

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …


Mitochondrial-Targeted Therapies In Traumatic Brain Injury: From Bench To Bedside, Sidra Tabassum, Silin Wu, Chang-Hun Lee, Bosco Seong Kyu Yang, Aaron M Gusdon, Huimahn A Choi, Xuefang S Ren 2025 The Texas Medical Center Library

Mitochondrial-Targeted Therapies In Traumatic Brain Injury: From Bench To Bedside, Sidra Tabassum, Silin Wu, Chang-Hun Lee, Bosco Seong Kyu Yang, Aaron M Gusdon, Huimahn A Choi, Xuefang S Ren

Faculty, Staff and Student Publications

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide, with limited effective therapeutic options currently available. Recent research has highlighted the pivotal role of mitochondrial dysfunction in the pathophysiology of TBI, making mitochondria an attractive target for therapeutic intervention. This review comprehensively examines advancements in mitochondrial-targeted therapies for TBI, bridging the gap from basic research to clinical applications. We discuss the underlying mechanisms of mitochondrial damage in TBI, including oxidative stress, impaired bioenergetics, mitochondrial dynamics, and apoptotic pathways. Furthermore, we highlight the complex interplay between mitochondrial dysfunction, inflammation, and blood-brain barrier (BBB) integrity, elucidating how these …


Pay Attention! A Comparative Analysis Of Psychological Assessments And Neurological Mechanisms For Adhd Within A Pediatric Population, Kristen E. Newberry 2025 Antioch University Seattle

Pay Attention! A Comparative Analysis Of Psychological Assessments And Neurological Mechanisms For Adhd Within A Pediatric Population, Kristen E. Newberry

Antioch University Dissertations & Theses

This study evaluated the predictiveness of the WISC-V, NEPSY-II, CPT-3, and CATA when compared to each other in a sample of 272 children aged 8–16. Archival data was analyzed using binary and multinomial logistic regression models to assess concurrent validity of specific subtests and indexes. Participants were grouped by ADHD subtype (inattentive, combined/hyperactive, or no diagnosis), with gender and executive functioning measures included in the models. Findings indicated that lower Cognitive Proficiency Index (CPI) and executive functioning scores (e.g., Animal Sorting, Response Set) predicted any ADHD diagnosis compared to the no diagnosis group, whereas higher CATA scores predicted lower Inattentive …


The Interplay Between Pulse Width And Activation Depth In Tens: A Computational Study, Alexander Guillen, Dennis Q Truong, Yusuf O Cakmak, Sheng Li, Abhishek Datta 2025 The Texas Medical Center Library

The Interplay Between Pulse Width And Activation Depth In Tens: A Computational Study, Alexander Guillen, Dennis Q Truong, Yusuf O Cakmak, Sheng Li, Abhishek Datta

Faculty, Staff and Student Publications

Background: Transcutaneous electrical nerve stimulation (TENS) has been a commonly used modality to relieve aches and pain for over 40 years. Commercially available devices provide multiple therapy modes involving a different combination of frequency and pulse width with intensity. While frequency sets sensation, intensity helps determine tolerability, longer pulse width is reported to induce a feeling of deeper stimulation. In fact, longer pulse width has been empirically shown to deliver current into deeper tissues, but in context of other electrical stimulation modalities. The goal of this study was to unpack the relationship between pulse width and activation depth in TENS. …


Virtually Assisted Home Rehabilitation After Acute Stroke (Vast-Rehab): A Descriptive Pilot Study For Young And Underserved Stroke Survivors, Emily A Stevens, Neha Muraly, Carolyn P Da Silva, Lorie Richards, Aylen Sosa, Heather Smith, Allyson Seals Richard, Shehzeen Manji, Mary E Russell, Sean I Savitz 2025 The Texas Medical Center Library

Virtually Assisted Home Rehabilitation After Acute Stroke (Vast-Rehab): A Descriptive Pilot Study For Young And Underserved Stroke Survivors, Emily A Stevens, Neha Muraly, Carolyn P Da Silva, Lorie Richards, Aylen Sosa, Heather Smith, Allyson Seals Richard, Shehzeen Manji, Mary E Russell, Sean I Savitz

Faculty, Staff and Student Publications

Introduction: The objective of Virtually Assisted home rehabilitation after acute STroke was to offer a fully remote telerehabilitation intervention to stroke survivors during the COVID-19 pandemic.

Methods: Participants were recruited from acute care, inpatient rehab, or provider/self-referral if they had a stroke within the previous year, prestroke modified Rankin Scale < 3, were recommended to participate in rehab, and had internet access. Exclusions were: prior injury/diagnoses that impacted functional level, life expectancy of less than six months, or safety concerns. Outcomes were within one week prior to initiation and within one week after completion of telerehabilitation sessions. Video call sessions were completed 1-2 times a week for 12 weeks. Occupational therapy, physical therapy, and/or speech therapy were provided. Analyses involved descriptive statistics; qualitative comments were aggregated and analyzed for broader themes. Twenty participants were consented.

Results: Of the 20 participants (39-71 years old, 35% White, 50% female), 12 completed study activities, five completed exit interview; 10 demonstrated improvement on National Institute of Health Stroke Scale from a mean of 5.6 at baseline to 2.7 at end of study, six demonstrated improvement in modified Rankin Score …


Case Report: Rare Intraventricular H3 K27-Altered Diffuse Midline Glioma In An Adult, Merari Jasso, Jay-Jiguang Zhu, Meenakshi B Bhattacharjee, Georgene W Hergenroeder 2025 The Texas Medical Center Library

Case Report: Rare Intraventricular H3 K27-Altered Diffuse Midline Glioma In An Adult, Merari Jasso, Jay-Jiguang Zhu, Meenakshi B Bhattacharjee, Georgene W Hergenroeder

Faculty, Staff and Student Publications

H3 K27-Altered Diffuse Midline Gliomas are commonly found in children and adolescents in midline locations such as the thalamus, brain stem, and spinal cord. It is rare for these tumors to affect adults and to occur in locations like the lateral ventricles. Despite aggressive treatment methodologies, there is no cure for this disease. The median survival is between 8-12 months. A 24-year-old white male presented to the emergency department due to severe headache refractory to pain medications with a 2-month history of progressive headaches and eventual memory problems. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an intraventricular enhancing …


Real-World Clinical Utility Of A Multi-Protein, Blood-Based Biomarker Assay For Disease Activity Assessments In Multiple Sclerosis., Angela Sanchez, Elisa Sheng, Sarah Eagleman, James L Eubanks, Patricia Izbicki, Shannon McCurdy, Matt Burril, Ferhan Qureshi, Ati Ghoreyshi, Mitzi Joi Williams, Megan Weigel, William Kilgo, Jacqueline Nicholas, Annette Okai, Martin Belkin, Julie Burnham, Yasir Jassam, Michael Sy, Taylor Gonyou 2025 OhioHealth

Real-World Clinical Utility Of A Multi-Protein, Blood-Based Biomarker Assay For Disease Activity Assessments In Multiple Sclerosis., Angela Sanchez, Elisa Sheng, Sarah Eagleman, James L Eubanks, Patricia Izbicki, Shannon Mccurdy, Matt Burril, Ferhan Qureshi, Ati Ghoreyshi, Mitzi Joi Williams, Megan Weigel, William Kilgo, Jacqueline Nicholas, Annette Okai, Martin Belkin, Julie Burnham, Yasir Jassam, Michael Sy, Taylor Gonyou

Neuroscience Articles

BACKGROUND: Blood-based biomarkers have emerged as promising tools to optimize treatment decisions in multiple sclerosis (MS) including initiation, switch, or cessation of disease modifying therapies.

OBJECTIVES: The clinically validated MS disease activity (MSDA) test measures 18 proteins to derive a disease activity score. This study tests the clinical utility of MSDA in real-world practice.

METHODS: Twenty clinicians from 14 clinics conducted a chart review utilizing a retrospective, longitudinal design, with a pre-post component. Chart reviews captured clinician decision-making before and after receipt of each MSDA result, while separate clinician assessments also captured the perceived impact of MSDA on MS management. …


An Evidence-Based Consensus For The Use Of Neurostimulation For The Treatment Of Non-Surgical Low Back Pain: The Neuron Group., Timothy Ray Deer, Jason E Pope, Erika A Petersen, Rany T Abdallah, Kasra Amirdelfan, Nomen Azeem, Vishal Bansal, Kaku Barkoh, Kenneth B Chapman, Daniel R Denis, Michael J Dorsi, Alexander Escobar, Steven Michael Falowski, Rosa Amelia Garcia, Jonathan M Hagedorn, Robert D Heros, Whitney S James, Hemant Kalia, Todd Lansford, Mark N Malinowski, Suzanne Marie Manzi, Pankaj Mehta, Robert Z Moghim, Gregory Anthony Moore, Soriaya Lizette Motivala, Yeshvant A Navalgund, Raj G Patel, Julie G Pilitsis, Michael E Schatman, Philip Michael Shumsky, Natalie Holmes Strand, Nestor D Tomycz, James J Yue, Dawood Sayed 2025 OhioHealth

An Evidence-Based Consensus For The Use Of Neurostimulation For The Treatment Of Non-Surgical Low Back Pain: The Neuron Group., Timothy Ray Deer, Jason E Pope, Erika A Petersen, Rany T Abdallah, Kasra Amirdelfan, Nomen Azeem, Vishal Bansal, Kaku Barkoh, Kenneth B Chapman, Daniel R Denis, Michael J Dorsi, Alexander Escobar, Steven Michael Falowski, Rosa Amelia Garcia, Jonathan M Hagedorn, Robert D Heros, Whitney S James, Hemant Kalia, Todd Lansford, Mark N Malinowski, Suzanne Marie Manzi, Pankaj Mehta, Robert Z Moghim, Gregory Anthony Moore, Soriaya Lizette Motivala, Yeshvant A Navalgund, Raj G Patel, Julie G Pilitsis, Michael E Schatman, Philip Michael Shumsky, Natalie Holmes Strand, Nestor D Tomycz, James J Yue, Dawood Sayed

Neuroscience Articles

INTRODUCTION: The use of electrical neuromodulation has often been limited to those with previous back surgery, peripheral neuropathy, and complex regional pain syndrome. Many patients with severe intractable low back pain were thought to be candidates for spinal cord stimulation (SCS), dorsal root ganglion stimulation, or peripheral nerve stimulation but did not meet the criteria. Recently, additional high-level data has supported the use of SCS in non-surgical low back pain (NSLBP), and United States Food and Drug Administration approval has been granted. The American Society of Pain and Neuroscience (ASPN) executive committee realized an unmet need to develop criteria for …


Levetiracetam-Induced Acute Kidney Injury In A Pediatric Patient, Makaila A. Geese PharmD Candidate, Norm Fenn BCPS, BCPPS 2025 Parkview Health

Levetiracetam-Induced Acute Kidney Injury In A Pediatric Patient, Makaila A. Geese Pharmd Candidate, Norm Fenn Bcps, Bcpps

Parkview Pharmacy Department

Presented at PPA Meeting.

Objective: To describe a case of acute kidney injury following levetiracetam administration in an adolescent patient.

Key takeaways:

Acute kidney injury (AKI) following levetiracetam is rare, especially in pediatric patients

Kidney injury was not correlated with supratherapeutic levetiracetam concentrations


Coldstartcpi: Induced-Fit Theory-Guided Dti Predictive Model With Improved Generalization Performance, Qichang Zhao, Haochen Zhao, Linyuan Gao, Kai Zheng, Yajie Li, Qiao Ling, Jing Tang, Yaohang Li, Jianxin Wang 2025 Central South University

Coldstartcpi: Induced-Fit Theory-Guided Dti Predictive Model With Improved Generalization Performance, Qichang Zhao, Haochen Zhao, Linyuan Gao, Kai Zheng, Yajie Li, Qiao Ling, Jing Tang, Yaohang Li, Jianxin Wang

Computer Science Faculty Publications

Predicting compound-protein interactions (CPIs) plays a crucial role in drug discovery. Traditional methods, based on the key-lock theory and rigid docking, often fail with novel compounds and proteins due to their inability to account for molecular flexibility and the high sparsity of CPI data. Here, we introduce ColdstartCPI, a framework inspired by induced-fit theory, which leverages unsupervised pre-training features and a Transformer module to learn both compound and protein characteristics. ColdstartCPI treats proteins and compounds as flexible molecules during inference, aligning with biological insights. It outperforms state-of-the-art sequence-based models, particularly for unseen compounds and proteins, and shows strong generalization capability …


Reassessing Hourly Neurological Assessments: A Quality Improvement Initiative, Haley Lynne Johnson 2025 West Virginia University

Reassessing Hourly Neurological Assessments: A Quality Improvement Initiative, Haley Lynne Johnson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Reassessing Hourly Neurological Assessments: A Quality Improvement Initiative

Haley Lynne Johnson, BSN, RN

Background: Stroke and brain injuries remain among the leading causes of mortality in the United States, accounting for 162,890 deaths in 2021 (Centers for Disease Control and Prevention [CDC], 2021). Although frequent neurological assessments are essential for monitoring patient status, limited evidence supports the prolonged use of hourly neuro-checks (LaBuzetta et al., 2022). Excessive neuro-check frequency has been linked to sleep deprivation, an increased risk of delirium, and inefficient resource utilization (Kishore et al., 2021).

Purpose: This project aimed to assess the impact of …


A Customized Large Single-Piece Bifrontal Implant For Post-Craniectomy Defect Reconstruction: A Case Study, Omid Ghaderzadeh, Ehsan Amirbeyk, Seyed Roholah Ghodsi, Zahra Namazi, Lobat Tayebi 2025 DanaWell Co.

A Customized Large Single-Piece Bifrontal Implant For Post-Craniectomy Defect Reconstruction: A Case Study, Omid Ghaderzadeh, Ehsan Amirbeyk, Seyed Roholah Ghodsi, Zahra Namazi, Lobat Tayebi

Electrical & Computer Engineering Faculty Publications

Background: Large bifrontal defects pose unique reconstruction challenges due to their complex curvature and mechanical requirements. This case demonstrated how computer-aided design/manufacturing (CAD/CAM) enabled precise single-piece polymethyl methacrylate (PMMA) implant fabrication, thereby overcoming traditional limitations. Case presentation: A 25-year-old male who had undergone bifrontal decompressive craniectomy suffered a severe traumatic brain injury. The autologous bone flap had been temporarily stored in a subcutaneous fat area of the abdomen for 3 months to preserve its viability. A secondary cranioplasty was then performed using titanium miniplates and self-tapping screws for final fixation. After 2 years, the patient developed empyema and a brain …


Independent Component Analysis Of Resting-State Fmri Identifies Regions Associated With Seizure Freedom After Laser Interstitial Thermal Therapy For Temporal Lobe Epilepsy, Mahdi Alizadeh, J. Miao, Caio Matias, Kevin J. Hines, Christopher T T. Skidmore, Michael R. Sperling, Joseph I Tracy, Ashwini Sharan, Chengyuan Wu 2025 Thomas Jefferson University

Independent Component Analysis Of Resting-State Fmri Identifies Regions Associated With Seizure Freedom After Laser Interstitial Thermal Therapy For Temporal Lobe Epilepsy, Mahdi Alizadeh, J. Miao, Caio Matias, Kevin J. Hines, Christopher T T. Skidmore, Michael R. Sperling, Joseph I Tracy, Ashwini Sharan, Chengyuan Wu

Department of Neurosurgery Faculty Papers

OBJECTIVE: Temporal lobe epilepsy (TLE) is a common form of drug-resistant epilepsy often treated with surgical interventions, including laser interstitial thermal therapy (LITT). However, patient-specific factors influencing LITT outcomes remain unclear. This retrospective study aimed to identify pre-operative resting-state functional MRI (rs-fMRI) patterns associated with seizure freedom following LITT in mesial TLE.

METHODS: We analyzed rs-fMRI data from 28 patients with mesial TLE who underwent LITT, classifying them into seizure-free (SF) and not seizure-free (NSF) groups based on 12-month post-operative outcomes. Independent component analysis (ICA) was used to identify subject-specific brain networks, and generalized linear models (GLM) were employed to …


Effect Of Implementing An Educational Program About Post Kidney Transplant Care On Critical Care Nurses' Knowledge, marwa abdo, asmaa ibrahim aboseda 2025 Mansoura University

Effect Of Implementing An Educational Program About Post Kidney Transplant Care On Critical Care Nurses' Knowledge, Marwa Abdo, Asmaa Ibrahim Aboseda

Nursing

Background: Critical care nurses (CCNs) play a pivotal role in post-kidney transplant care, necessitating a comprehensive understanding of transplantation procedures, complications, and patient management. So, any knowledge gaps among CCNs may impact the quality of care provide to kidney transplant program. Aim: This study aimed to assess the effect of implementing an educational program about post-kidney transplant care on critical care nurses’ knowledge. Methods: A quasi-experimental study was conducted among 50 critical care nurses. A structured educational program was implemented, and nurses’ knowledge was assessed pre- program, post- program, and three months follow-up. Data was collected using a kidney transplantation …


Molecular Mechanism Governing The Plasticity Of Use-Dependent Spike Broadening In Dorsal Root Ganglion Neurons, Tyler D. Alexander, Stephen Tymanskyj, Kyle J. Kennedy, Leonard K. Kaczmarek, Manuel Covarrubias 2024 Thomas Jefferson University

Molecular Mechanism Governing The Plasticity Of Use-Dependent Spike Broadening In Dorsal Root Ganglion Neurons, Tyler D. Alexander, Stephen Tymanskyj, Kyle J. Kennedy, Leonard K. Kaczmarek, Manuel Covarrubias

SKMC Student Presentations and Publications

Use-dependent spike broadening (UDSB) results from inactivation of the voltage-gated K+ (Kv) channels that regulate the repolarization of the action potential. However, the specific signaling and molecular processes that modulate UDSB have remained elusive. Here, we applied an adeno-associated viral vector approach and dynamic clamping to conclusively demonstrate how multisite phosphorylation of the N-terminal inactivation domain (NTID) of the Kv3.4 channel modulates UDSB in rat dorsal root ganglion (DRG) neurons. The Kv3.4 phosphonull variant promotes slow recovery from inactivation, cumulative inactivation, and UDSB. In contrast, the Kv3.4 phosphomimic variant promotes fast recovery from inactivation and robust resistance to cumulative inactivation …


Occupational Therapy Using Cbt To Improve Work Productivity In Schizophrenia: A Case Study, Artha Nisa Thohiroh Triyantari, Reza Nur Arsyi, Muhammad Luthfi, Ayleen Alicia K, Hermito Gideon, Zulfa Khoirunisah, Putri Dirgantara, Purnama Betty R. Sitorus 2024 Universitas Indonesia

Occupational Therapy Using Cbt To Improve Work Productivity In Schizophrenia: A Case Study, Artha Nisa Thohiroh Triyantari, Reza Nur Arsyi, Muhammad Luthfi, Ayleen Alicia K, Hermito Gideon, Zulfa Khoirunisah, Putri Dirgantara, Purnama Betty R. Sitorus

Jurnal Fisioterapi Terapan Indonesia

Schizophrenia is a chronic mental disorder that often impairs an individual's social and occupational functioning, including productivity-related activities. Patients with schizophrenia frequently face challenges in maintaining employment or running an independent business due to cognitive and emotional disturbances affecting their adaptive skills. This single-case study integrates Cognitive Behavioral Therapy (CBT) into occupational therapy to enhance productivity in a schizophrenia patient through an entrepreneurial activity—independently opening a coffee shop. The study subject is a 50-year-old male diagnosed with schizophrenia undergoing psychosocial rehabilitation at RSJ Dr. Soeharto Heerdjan. The CBT-based intervention was designed to develop adaptive thinking patterns and occupational skills through …


Enhancement Of Functional Ability In Supraspinatus Tendinitis Using Ultrasound And Isotonic Exercise: Case Study, Tu Lidya Ike Putri, Christabelle Aurelia 2024 Universitas Indonesia

Enhancement Of Functional Ability In Supraspinatus Tendinitis Using Ultrasound And Isotonic Exercise: Case Study, Tu Lidya Ike Putri, Christabelle Aurelia

Jurnal Fisioterapi Terapan Indonesia

Supraspinatus tendinitis is an inflammation of the supraspinatus tendon caused by the supraspinatus muscle tendon overlapping with the caput longus bicep tendon so that friction and repetitive pressure occur over a long period of time and result in damage to the supraspinatus muscle tendon and supraspinatus tendinitis occurs. Characterized by complaints of pain around the shoulder followed by limitation of motion in the shoulder joint. The clinical question arises "can the application of ultrasound and isotonic exercise reduce pain and functional ability improvement?". To be able to answer this question, an evidence search was conducted on 3 data bases, namely …


Perbandingan Konservatif Fisioterapi Dengan Core Stability Exercise Pada Kasus Nyeri Punggung Bawah, Angria Pradita, Nurul Halimah 2024 Institut Teknologi Sains dan Kesehatan Rs. dr. Soepraoen Kesdam V/Brw

Perbandingan Konservatif Fisioterapi Dengan Core Stability Exercise Pada Kasus Nyeri Punggung Bawah, Angria Pradita, Nurul Halimah

Jurnal Fisioterapi Terapan Indonesia

ABSTRACT: Low back pain is a major complaint caused by multifactorial conditions. The most common factors of low back pain complaints are due to age, occupation and gender. This study aims to compare the differences in therapeutic effects of conservative physiotherapy with the provision of electrotherapy, namely; microwave diathermy combined with transcutaneous electrical nerve stimulation (TENS), core stability exercise techniques and a combination of electrotherapy with core stability exercise (CSE). This type of research is quasi experimental with a pre-post test design in a population of 90 low back pain patients who seek treatment at the Physiotherapy clinic. By using …


Neurofilament Light Chain In Serum Of Cancer Patients With Acute Neurological Complications, Amulya Gottiparthy, Keng Lam, Suprateek Kundu, Zixi Yang, Ivo Tremont-Lukats, Sudhakar Tummala 2024 The Texas Medical Center Library

Neurofilament Light Chain In Serum Of Cancer Patients With Acute Neurological Complications, Amulya Gottiparthy, Keng Lam, Suprateek Kundu, Zixi Yang, Ivo Tremont-Lukats, Sudhakar Tummala

Faculty, Staff and Student Publications

Aim: Neurofilament light chain (NfL) is a nonspecific sensitive biomarker of axonal damage.

Methods: This case series identified cancer patients with neurological complications who had serum NfL measurements and paired these results to outcomes.

Results: NfL serum levels were available in 15 patients with hematological malignancies or solid tumors. The neurological complications studied were immune effector cell-associated neurotoxicity syndrome, immune checkpoint inhibitor-related encephalopathy, anoxic brain injury, Guillain-Barre syndrome, hemophagocytic lymphohistiocytosis, transverse myelitis, paraneoplastic syndrome, central nervous system demyelinating disorder and chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. All patients but one with serum NfL >900 pg/ml died …


Effectiveness Of Using Soft Exosuit In Stroke Case To Improve Walking Speed And Endurance, Aditya Denny Pratama, Rakha Shidqi Widyadhana 2024 universitas indonesia

Effectiveness Of Using Soft Exosuit In Stroke Case To Improve Walking Speed And Endurance, Aditya Denny Pratama, Rakha Shidqi Widyadhana

Jurnal Fisioterapi Terapan Indonesia

Stroke is a clinically defined syndrome of acute, focal nerve discharge caused by vascular injury (infarction, hemorrhage) of the central nervous system. Punches can cause damage to the brain and affect a person's ability to walk, balance and coordinate movements. Impaired gait is common in stroke cases, often resulting in poor recovery of mobility and inability to carry out daily activities without assistance. One of the interventions that can be used is a soft exosuit. This method can help overcome walking problems in stroke patients where soft exosuits are used to increase walking speed and walking endurance. The purpose of …


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