Katherine Anne McGirr

Adherence to Commonly Prescribed, Home-based Strength Training Exercises for the Lower Extremity Can Be Objectively Monitored Using the Bandcizer

Abstract Rathleff, MS, Thorborg, K, Rode, LA, McGirr, KA, Sørensen, AS, Bøgild, A, and Bandholm, T. Adherence to commonly prescribed, home-based strength training exercises for the lower extremity can be objectively monitored using the Bandcizer. J Strength Cond Res 29(3): 627–636, 2015—The purpose of this study was to investigate the validity of automatically stored exercise data from the elastic band sensor compared with those of a gold-standard stretch sensor during exercises commonly used for rehabilitation of the hip and knee. The design was a concurrent validity study. Participants performed 3 sets of 10 repetitions of 6 exercises with both sensors attached to the same elastic exercise band. These were knee extension, knee flexion, hip abduction and adduction, hip flexion, and hip external rotation. Agreement between methods was calculated for date, time of day, repetitions, total and single repetition, and contraction phase–specific time under tension (TUT). Files from the elastic band sensor contained identical dates, time of day, and number of repetitions for each exercise set compared with those for the gold standard. Total TUT and total single repetition TUT were highly correlated with the stretch sensor (r = 0.83–0.96) but lower for contraction phase–specific TUTs (r = 0.45–0.94). There were systematic differences between the methods ranging from 0.0 to 2.2 seconds (0.0–6.3%) for total TUT and total single repetition TUT, and between 0.0 and 3.3 seconds (0.0–33.3%) for contraction phase–specific TUTs. The elastic band sensor is a valid measure of date, time of day, number of repetitions and sets, total TUT, and total single repetition TUT during commonly used home-based strength training exercises. However, the elastic band sensor seems unable to validly measure TUT for specific contraction phases.

New exercise-integrated technology can monitor the dosage and quality of exercise performed against an elastic resistance band by adolescents with patellofemoral pain: an observational study

QUESTION Is the exercise-integrated Bandcizer™ system feasible for recording exercise dosage (time under tension (TUT) and repetitions) and pain scores among adolescents with patellofemoral pain? Do adolescents practise the exercises as prescribed (TUT and repetitions)? Do adolescents accurately report the exercises they do in an exercise diary? DESIGN Observational feasibility study. PARTICIPANTS Twenty adolescents between 15 and 19 years of age with patellofemoral pain. INTERVENTION Participants were prescribed three exercise sessions per week (one with and two without supervision) for 6 weeks. The exercises included three hip and one knee exercise with an elastic resistance band. Participants were instructed to perform three sets with a predefined TUT (3seconds concentric; 2seconds isometric; 3seconds eccentric; 2seconds pause), equating to 80seconds for 10 repetitions (one set). OUTCOME MEASURES The exercise-integrated system consisted of a sensor attached to the elastic resistance band that was connected to the Bandtrainer app on an electronic tablet device. Pain intensity was reported on a visual analogue scale on the app. Participants also completed a self-report exercise diary. RESULTS No major problems were reported with the system. Participants performed 2541 exercise sets during the 6 weeks; 5% were performed with the predefined TUT (ie, within 10seconds of the 80-second target) and 90% were performed below the target TUT. On average, the participants received 15% of the instructed exercise dosage based on TUT. The exercise dosage reported in the exercise diaries was 2.3 times higher than the TUT data from the electronic system. Pain intensity was successfully collected in 100% of the exercise sets. CONCLUSION The system was feasible for adolescents with patellofemoral pain. The system made it possible to capture detailed data about the TUT, repetitions and sets during home-based exercises together with pain intensity before and after each exercise. [Rathleff MS, Bandholm T, McGirr KA, Harring SI, Sørensen AS, Thorborg K (2016) New exercise-integrated technology can monitor the dosage and quality of exercise performed against an elastic resistance band by adolescents with patellofemoral pain: an observational study.Journal of Physiotherapy62: 159-163].

Translation and validation of the Child and the Adolescent HARDSHIP (Headache-attributed restriction, disability, social handicap and impaired participation) questionnaire into Danish language

Background. The prevalence of headaches among children and adolescents varies considerably between countries. This may be due to a lack of appropriate instruments to capture the prevalence. The purpose of this study was to translate the Child and Adolescent HARDSHIP questionnaires from English into Danish language, conduct cross-cultural adaptation, face validation by cognitive interviewing and conduct a pilot study exploring time requirements. Methods. The questionnaire was translated using the guidelines proposed by “The Global Campaign to Reduce the Burden of Headache.” A total of 25 children from 6 to 12 years of age completed the questionnaire with 24 h between test and retest to assess reliability. A total of 169 children and adolescents from 6 to 17 years of age completed the translated questionnaire to assess time requirements for completing it. Results. Only minor discrepancies were observed in the translation process. Test-retest reliability of the translated questionnaire showed substantial agreement (kappa: 0.65–0.78). The questionnaires were completed within 30 min (age 6–11 years of age) and within 15 min (age 12–17 years of age) respectively. Discussion. No major problems were observed in the forward translations of the questionnaires. The face validation prompted no major changes in the questionnaire. The face-to-face interviews showed that pupils of different ethnic backgrounds than Danish and pupils in the age group of 6–11 had more difficulty in understanding a minority of the questions. The Danish Child and Adolescent HARDSHIP questionnaire therefore complies with the intentions of the originators, aiming at a maximal completion time of 45 min and in comparison with actual completion time. The test-retest study showed substantial agreement between test and retest in the headache, migraine and MOH domains and questions referring to time.The Child and Adolescent HARDSHIP questionnaire, includes a section specifically recording a four-week period.The Child and Adolescent HARDSHIP questionnaire is intended to measure burden of headache in large populations and there is therefore no need to reflect the states of individuals. We therefore find the substantial reliability of the Danish version of the Child and Adolescent HARDSHIP questionnaire to be adequate, without supplementing with a diary. The pilot study indicates that headache is a major problem among children and adolescents in Denmark. A total of 95.3% of the pupils have experienced headache in their life, 76.6% during the last year. A total of 14% left school early because of their headache and 14.9% missed school during the last four weeks, due to headache. 49.2% have experienced headaches during the last week and 47% describe the headache as “quite bad.” A total of 24.1% have taken pills or medicine during the last week due to headache. This pilot study clearly demonstrates the need to investigate the burden of headache among Danish schoolchildren as it seems to have a profound effect on their lives.

Manipulation of the body schema – Unilateral manual stimulation of lower extremity influences weight distribution in standing position

Clinical experience advocates sensory stimulation to increase the body sensation and adjust the body schema, which may be disturbed in some patients. Unilateral massage may affect the body midline orientation, but little evidence is available to support the effect of this practice. Twenty-one healthy young people participated in this experimental study. Two force plates measured weight distribution between the legs in standing position before and after unilateral manual stimulation of the lower extremities. Stimulation of the leg with initial least weight-bearing increased the load on this leg significantly from 48.2% to 49.0% and a similar but reverse effect was seen when stimulating the contra-lateral leg. When analysing the data with respect to stimulation of the non-dominant leg, the stimulation increased the weight-bearing on this leg from 49.6% to 51.3%. These findings indicate that external afferent stimuli may enhance the body perception and influence the body schema and midline orientation.