ABSTRACT
The current pandemic due to Covid-19 and its consequent social distancing has accelerated the transformation of traditional education towards online education. However, this transformation has been adapted at a technological level, but not pedagogically. This study has aimed to analyze the acquisition of anatomical knowledge of CAFD students using videos and static images of surfing managed through a blog. A total of 106 students from the CAFD degree at the University of Murcia completed this work. In addition, an exam containing five questions on the anatomy applied to surfing was carried out to analyze the effect on learning after viewing the videos/images. After the statistical analysis, a percentage of correct answers of 66.0%, 51.9%, 62.3%, and 63.2% was observed for questions 1, 2, 4 and 5. This methodology, based essentially on an analysis of movement, allows a functional understanding of the anatomy of the locomotor system in the adventure sport of surfing. These results show a practical and novel methodology for the development of online teaching. Furthermore, they reveal the broad scope for improving the teaching of anatomy in CAFD through the combined use of new technologies.
ABSTRACT
Objective: Alexander technique (AT) is a cognitive embodiment approach applied during daily life. We tested the feasibility and potential of online AT-based group courses for people living with PD (PwP) and included care partners to enhance dyadic relationship and retention of benefits. Background: An RCT showed that 1:1 AT sessions reduced motor symptoms in PwP with retention of benefits at 6 months [1-2]. Recent data suggest in-person AT-based group courses also hold promise. The COVID-19 pandemic gave an opportunity to test synchronous online AT-based courses. Methods: Design: Uncontrolled feasibility trial;3 groups met for 105 min, twice/wk, for 8 or 9 wks. Participants: 16 PwP and 14 care partners began the course. Intervention: Courses were delivered in-home via Zoom. Coursework included functional anatomy and self-management strategies via verbal instruction, anatomical models and images, demonstration, and activities. AT principles were embedded in everyday acts such as gait, sit-to-stand, speech, and IADLs. Review handouts and session recordings were provided. Outcome Measures: Functional reach, one-leg stance, TUG, 7-item Physical Performance Test, symptommanagement self-report, anonymous course evaluations, posture photos, audio interviews. Results: 94% of PwP completed the course (c.f. 65% for in-person course). Average course attendance by PwP was 86% (c.f. 91% in-person). PwP improved functional reach (p = .03) and simulated eating (p = .06). Subjectively, PWP reported improved physical self-control and ability to manage falls, shuffling gait, upright posture, garbled speech, and anxiety (all p < .05). On a 0-10 scale, evaluations averaged >9 for novelty of ideas and practicality of tools for physical symptom-management and for care partners' likelihood to remember and use what they had learned, and > 8.5 for everyone feeling better prepared to meet the daily demands of living with PD. Conclusion: AT training shows promise to improve selfmanagement of PD motor and non-motor symptoms. Online classes can increase accessibility and retention for PwP and their care partners. Larger RCTs are needed to statistically verify improvement, optimize delivery, compare to other approaches, and investigate AT combined with exercise. Six-month follow-up data are being collected for presentation, along with subjective data from care partners about their partners' symptom management.
ABSTRACT
The coronavirus disease-19 (COVID-19) pandemic has prompted new interest among anesthesiologists and intensivists in controlling coughing and expectoration of potentially infectious aerosolized secretions during intubation and extubation. However, the fear of provoking laryngospasm may cause avoidance of deep or sedated extubation techniques which could reduce coughing and infection risk. This fear may be alleviated with clear understanding of the mechanisms and effective management of post-extubation airway obstruction including laryngospasm. We review the dynamic function of the larynx from the vantage point of head-and-neck surgery, highlighting two key concepts: 1. The larynx is a complex organ that may occlude reflexively at levels other than the true vocal folds; 2. The widely held belief that positive-pressure ventilation by mask can "break" laryngospasm is not supported by the otorhinolaryngology literature. We review the differential diagnosis of acute airway obstruction after extubation, discuss techniques for achieving smooth extubation with avoidance of coughing and expectoration of secretions, and recommend, on the basis of this review, a clinical pathway for optimal management of upper airway obstruction including laryngospasm to avoid adverse outcomes.