Drawing Direction Effect on a Task's Performance Characteristics among People with Essential Tremor.

Essential tremor (ET) is a common movement disorder affecting the performance of various daily tasks, including drawing. While spiral-drawing task characteristics have been described among patients with ET, research about the significance of the drawing direction of both spiral and lines tasks on the performance process is scarce. This study mapped inter-group differences between people with ET and controls related to drawing directions and the intra-effect of the drawing directions on the tremor level among people with ET. Twenty participants with ET and eighteen without ET drew spirals and vertical and horizontal lines on a digitizer with an inking pen. Time-based outcome measures were gathered to address the effect of the drawing directions on tremor by analyzing various spiral sections and comparing vertical and horizontal lines. Significant group differences were found in deviation of the spiral radius from a filtered radius curve and in deviation of the distance curve from a filtered curve for both line types. Significant differences were found between defined horizontal and vertical spiral sections within each group and between both line types within the ET group. A significant correlation was found between spiral and vertical line deviations from filtered curve outcome measures. Achieving objective measures about the significance of drawing directions on actual performance may support the clinical evaluation of people with ET toward developing future intervention methods for improving their functional abilities.

Advancing global health through engineering: a perspective on teaching an online global health course to engineers during a global pandemic.

BACKGROUND: The effect of the COVID-19 pandemic on higher education has been felt worldwide. There are many lessons to be learned about teaching and learning in the digital age. While we evaluate the full impact and prepare ourselves for the new normal, it is worth reflecting on some of the positive aspects of online teaching and learning and understanding how students, teachers and the wider faculty have been able to support each other through the challenges of the pandemic. In this article, we offer a perspective on teaching an online Global Health course to engineering students. RESULTS: The course, taught by a physician, provides a grounding in basic medical, scientific and engineering principles and is available to students of diverse engineering specialties. Students developed skills and gained confidence in active listening, sourcing and critical appraisal of information, interdisciplinary teamwork, needs assessment, problem analysis, problem-solving, effective communication, and organisation and delivery of information (in English). Students learned the importance of engineering in landmark historical public health projects, the delivery of modern health care, and the pressing need to develop engineering solutions to current global health problems. Course assessment was formative: 20% attendance and active participation in online classes, 30% problem-solving, 30% student presentations, and 20% written abstracts for two class projects: historical innovations and medicine in the future. CONCLUSIONS: We show how, through conversion from a classroom to an online format, we were able to deliver a rich curriculum with sound assessment where students were able to innovate together and discover the importance of engineering in health and well-being as we all experience an unprecedented global health pandemic.

The Effect of an Interphase Interval on Electrically Induced Dorsiflexion Force and Fatigue in Subjects With an Upper Motor Neuron Lesion.

The study objective was to investigate the effects of an interphase interval (IPI) interposed between the two phases of a biphasic symmetric pulse, on electrically induced contraction (EIC) forces and fatigue during stimulation of the ankle dorsiflexors in individuals with an upper motor neuron lesion (UMNL). The dorsiflexor muscles of 20 subjects with UMNL routinely using functional electrical stimulation to correct a foot drop during ambulation, were electrically stimulated with biphasic pulses (250 µs phase duration and 35 Hz pulse frequency) using nine IPI durations (ranging from 0 to 400 µs). The induced muscle force and fatigue were measured. A significant positive correlation was found between IPI duration and induced muscle force. Introducing a 250 µs IPI significantly decreased rate of muscle fatigue compared to stimulation with no IPI (P < 0.05). Thus, the introduction of an IPI may reduce the current intensity required to achieve a specific force during functional electrical stimulation in individuals with UMNL. Reduction in muscle fatigue may shorten the conditioning period necessary for first time users of functional electrical stimulation.

The effect of electrode placement and interphase interval on force production during stimulation of the dorsiflexor muscles.

The aims of this study were to investigate whether introducing an interphase interval (IPI) to biphasic pulses during stimulation of the dorsiflexor muscles would affect force production and to determine whether the IPI effect is dependent on electrode position. Twelve healthy volunteers participated in the study. Each subject participated in one session during which electrically induced contraction (EIC) forces of the ankle dorsiflexors were measured with five different IPI settings ranging from 0 to 400 µs. Forces of EICs were assessed with the electrodes placed either with the proximal electrode positioned over the common peroneal nerve and the second electrode over the dorsiflexor muscles or with both electrodes located over the dorsiflexor muscles. The order of electrode placements and of the different IPI settings was randomized across subjects. The results indicated that the introduction of a 100-µs-long IPI may enhance force production when one electrode is located over the common peroneal nerve. However, increasing the duration of the IPI beyond 100 µs did not result in further increase in force production. In contrast, the introduction of an IPI did not increase force production when both electrodes were located over the dorsiflexor muscles. These findings may help to optimize stimulation settings during functional electrical stimulation to prevent foot-drop.