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Caroline W Stegink Jansen

Publications and source records attributed to Caroline W Stegink Jansen.

5 recordsLinked to original sources

Multidimensional EMG-based assessment of walking dynamics.

The electromyogram (EMG) provides a measure of a muscle's involvement in the execution of a motor task. Successful completion of an activity, such as walking, depends on the efficient motor control of a group of muscles. In this paper, we present a method to quantify the intricate phasing and activation levels of a group of muscles during gait. At the core of our method is a multidimensional representation of the EMG activity observed during a single stride. This representation is referred to as a "trajectory." A hierarchical clustering procedure is used to identify representative classes of muscle activity patterns. The relative frequencies with which these motor patterns occur during a session (i.e., a series of consecutive strides) are expressed as histograms. Changes in walking strategy will be reflected as changes in the relative frequency with which specific gait patterns occur. This method was evaluated using EMG data obtained during walking on a level and a moderately-inclined treadmill. It was found that the histogram changes due to artificially altered gait are significantly larger than the changes due to normal day-to-day variability.

Algorithms↗

Development of the Functional Dexterity Test (FDT): construction, validity, reliability, and normative data.

Dexterity tests take time to administer; however, the information obtained is an important component of a comprehensive examination of the hand. This article introduces a dexterity test suitable for use as part of routine examination of the hand. The Functional Dexterity Test (FDT) was developed as a measure of dexterity that takes a minimum amount of time to administer, yet provides information regarding the patient's ability to use the hand for daily tasks requiring a 3-jaw chuck prehension between the fingers and the thumb. The test was developed over 20 years. Interrater and intrarater reliability ranges between good and excellent. Construct validity was confirmed in 2 clinical studies. Preliminary normative data were obtained in 6 samples of convenience. Along with statistical data, this article provides equipment standards and instructions.

Adult↗

Outcomes, treatment effectiveness, efficacy, and evidence-based practice: examples from the world of splinting.

Calls for outcome studies and evidence-based practice leave many therapists bewildered as to the meaning of various types of terminology. The objectives of this paper are to 1) review the structure of outcome reports and research; 2) describe the background and discuss the terms "treatment efficacy, "effectiveness," and "evidence-based practice"; 3) discuss these concepts as they apply to selected studies found in the literature that report the use of splints for patients with ailments that affect the use of their hands; and 4) provide some reflections that place these terms in the context of scientific inquiry and clinical practice. It is concluded that health care is being reviewed on an increasingly more systematic and grand scale. While studies that include large numbers of subjects are needed to substantiate the effectiveness of splinting, studies involving smaller numbers of subjects can contribute greatly as well, so long as they are performed with the highest level of study design and use standardized outcome measures that are valid for answering the designated research questions.

Evidence-Based Medicine↗

Measurement of maximum voluntary pinch strength: effects of forearm position and outcome score.

The purpose of this study was to determine the effects of forearm position and outcome score on key, fingertip, and three-jaw chuck pinch strength. Maximum voluntary key, fingertip, and three-jaw chuck pinches were performed by 135 healthy adults (20-88 years old) three times in a pronated, supinated, and neutral forearm position with the right and left hand using a B&L (B&L Engineering, Tustin, CA) pinch gauge. The highest, first, and mean scores of three pinch forces were recorded. Three 3 x 3 factorial repeated-measures analyses tested each type of pinch strength. Forearm position affected key and fingertip pinches (p<0.017; effect sizes <0.14) but not three-jaw chuck pinch. The highest score ranked highest followed by the first and then the mean of the three scores (p<0.017; effect sizes >0.53). Although the effects of type of outcome score were consistent, the statistically significant effects of forearm position and outcome score may be too small (<1 lb) to be clinically relevant. Standardized positioning during pinch strength measurement is still recommended despite these findings.

Adult↗