Physical therapy students' perceptions of team-based learning in gross anatomy using the Team-Based Learning Student Assessment Instrument.

PURPOSE: The objective of this study was to assess physical therapy student perceptions of team-based learning (TBL) in a graduate level gross anatomy course using the TBL Student Assessment Instrument (TBL-SAI). METHODS: The TBL-SAI was administered to 85 doctor of physical therapy (DPT) students, comprising three cohorts (classes of 2013, 2014, and 2015), who successfully completed a gross anatomy course where TBL was implemented. The TBL-SAI surveys 33 items, each rated from one (strongly disagree) to five (strongly agree) and measures three subscales: students' perceptions of accountability, preference for lecture or TBL, and student satisfaction. RESULTS: The means for each subscale and the total TBL-SAI score for each cohort fell above the neutral score. The 2015 group (mean, 37.97; 95% confidence interval [CI], 35.67 to 40.26) reported significantly higher satisfaction than that of the 2013 group (mean, 32.71; 95% CI, 30.31 to 35.05) and the 2014 group (mean, 33.11; 95% CI, 30.69 to 35.53). The 2015 group (mean, 125.3; 95% CI, 120.6 to 130.3) also had a significantly higher total score than that of the 2013 group (mean, 115.6; 95% CI, 110.5 to 120.5). CONCLUSION: The physical therapy students reported an overall positive experience in using TBL to learn gross anatomy in terms of accountability, preference for learning mode, and satisfaction. This positive experience with TBL was accompanied by their successful academic performance. Given the traits and learning preferences in this generation of graduate students, TBL could be a teaching method that is received positively elsewhere and results in successful academic performance and learning.

Effects of reinnervation of the biarticular shoulder-elbow muscles on joint kinematics and electromyographic patterns of the feline forelimb during downslope walking.

Full recovery of the forelimb kinematics during level and upslope walking following reinnervation of the biarticular elbow extensor suggests that the proprioceptive loss is compensated by other sensory sources or altered central drive, yet these findings have not been explored in downslope walking. Kinematics and muscle activity of the shoulder and elbow during downslope locomotion following reinnervation of the feline long head of the triceps brachii (TLo) and biceps brachii (Bi) were evaluated (1) during paralysis and (2) after the motor function was recovered but the proprioceptive feedback was permanently disrupted. The step cycle was examined in three walking conditions: level (0%), -25% grade (-14° downslope) and -50% grade (-26.6° downslope). Measurements were taken prior to and at three time points (2 weeks, and 1 and 12+ months) after transecting and suturing the radial and musculocutaneous nerves. There was an increase in the yield (increased flexion) at the elbow and less extensor activity duration of flexion during stance as the downslope grade increased. There were two notable periods of eccentric contractions (active lengthening) providing an apparent 'braking' action. Paralysis of the TLo and the Bi resulted in uncompensated alterations in shoulder-elbow kinematics and motor activity during the stance phase. However, unlike the case for the level and upslope conditions, during both paralysis and reinnervation, changes in interjoint coordination persisted for the downslope condition. The lack of complete recovery in the long term suggests that the autogenic reflexes contribute importantly to muscle and joint stiffness during active lengthening.

Effects of reinnervation of the triceps brachii on joint kinematics and electromyographic patterns of the feline forelimb during level and upslope walking.

Nerve injury in the hindlimb of the cat results in locomotor changes, yet these findings have not been explored in a more multifunctional forelimb. Kinematics and muscle activity of the shoulder and elbow during level and upslope locomotion following reinnervation of the feline long head of the triceps brachii (TLo) were evaluated (1) during paralysis [none to minimum motor activity (short-term effects)] and (2) after the motor function was recovered but the proprioceptive feedback was permanently disrupted (long-term effects). The step cycle was examined in three walking conditions: level (0%), 25% grade (14° upslope) and 50% grade (26.6° upslope). Measurements were taken prior to and at three time points (2 weeks, 1 month and 12+ months) after transecting and suturing the radial nerve of TLo. There was less of a yield (increased flexion) at the elbow joint and more extensor activity during elbow flexion during stance (E2) as the grade of walking increased. Substantial short-term effects were observed at the elbow joint (increased flexion during E2) as well as increased motor activity by the synergistic elbow extensors, and greater shoulder extension at paw contact, leading to altered interjoint coordination during stance. Forelimb shoulder and elbow kinematics during level and upslope locomotion progressed back to baseline at 12 months. The short-term effects can be explained by both mechanical and neural factors that are altered by the functional elimination of the TLo. Full recovery of the forelimb kinematics during level and upslope walking suggests that the proprioceptive length feedback loss is compensated by other sensory sources or altered central drive.