Methodology and Experimental Protocol for Studying Learning and Motor Control in Neuromuscular Structures in Pilates.

The benefits of Pilates have been extensively researched for their impact on muscular, psychological, and cardiac health, as well as body composition, among other aspects. This study aims to investigate the influence of the Pilates method on the learning process, motor control, and neuromuscular trunk stabilization, specifically in both experienced and inexperienced practitioners. This semi-randomized controlled trial compares the level of experience among 36 Pilates practitioners in terms of motor control and learning of two Pilates-based skills: standing plank and side crisscross. Data will be collected using various assessment methods, including abdominal wall muscle ultrasound (AWMUS), shear wave elastography (SWE), gaze behavior (GA) assessment, electroencephalography (EEG), and video motion. Significant intra- and inter-individual variations are expected, due to the diverse morphological and psychomotor profiles in the sample. The adoption of both linear and non-linear analyses will provide a comprehensive evaluation of how neuromuscular structures evolve over time and space, offering both quantitative and qualitative insights. Non-linear analysis is expected to reveal higher entropy in the expert group compared to non-experts, signifying greater complexity in their motor control. In terms of stability, experts are likely to exhibit higher Lyapunov exponent values, indicating enhanced stability and coordination, along with lower Hurst exponent values. In elastography, experienced practitioners are expected to display higher transversus abdominis (TrA) muscle elasticity, due to their proficiency. Concerning GA, non-experts are expected to demonstrate more saccades, focus on more Areas of Interest (AOIs), and shorter fixation times, as experts are presumed to have more efficient gaze control. In EEG, we anticipate higher theta wave values in the non-expert group compared to the expert group. These expectations draw from similar studies in elastography and correlated research in eye tracking and EEG. They are consistent with the principles of the Pilates Method and other scientific knowledge in related techniques.

Blueberry Counteracts Prediabetes in a Hypercaloric Diet-Induced Rat Model and Rescues Hepatic Mitochondrial Bioenergetics.

The paramount importance of a healthy diet in the prevention of type 2 diabetes is now well recognized. Blueberries (BBs) have been described as attractive functional fruits for this purpose. This study aimed to elucidate the cellular and molecular mechanisms pertaining to the protective impact of blueberry juice (BJ) on prediabetes. Using a hypercaloric diet-induced prediabetic rat model, we evaluated the effects of BJ on glucose, insulin, and lipid profiles; gut microbiota composition; intestinal barrier integrity; and metabolic endotoxemia, as well as on hepatic metabolic surrogates, including several related to mitochondria bioenergetics. BJ supplementation for 14 weeks counteracted diet-evoked metabolic deregulation, improving glucose tolerance, insulin sensitivity, and hypertriglyceridemia, along with systemic and hepatic antioxidant properties, without a significant impact on the gut microbiota composition and related mechanisms. In addition, BJ treatment effectively alleviated hepatic steatosis and mitochondrial dysfunction observed in the prediabetic animals, as suggested by the amelioration of bioenergetics parameters and key targets of inflammation, insulin signaling, ketogenesis, and fatty acids oxidation. In conclusion, the beneficial metabolic impact of BJ in prediabetes may be mainly explained by the rescue of hepatic mitochondrial bioenergetics. These findings pave the way to support the use of BJ in prediabetes to prevent diabetes and its complications.

Effectiveness of Simulation Training on Graduate Audiology Students' Auditory Brainstem Response Testing Skills.

Purpose Simulation is a tool commonly used in the clinical training of students within the health professions fields, such as medicine and nursing. The effectiveness of simulation as a teaching technique has been extensively documented in numerous health care professions; however, little is known about the effectiveness of simulation techniques in audiology education. This study assesses the effectiveness of a simulation activity focused on auditory brainstem response (ABR) testing conducted with students of an applied doctoral program in audiology. Method Twelve 2nd year audiology graduate students enrolled in the auditory electrophysiology course at Towson University in Fall 2018 participated in this pre-post study. Over a 3-week period, each student (a) received didactic instruction in ABR testing, (b) underwent a presimulation exercise skills assessment, (c) participated in a simulation exercise, and (d) underwent a postsimulation exercise skills assessment. Results Significant improvements were observed in clinical skill level for the ABR tasks evaluated in terms of both accuracy and efficiency (time in seconds needed to complete the task). The tasks evaluated included skin preparation, identification of scalp electrode placement sites, and scalp electrode placement in a variety of configurations (single- and two-channel arrays, horizontal and vertical electrode montages). Benefits associated with simulation-based instruction varied by clinical skill as well as by student. Conclusions The data described in this study reinforce the need to incorporate simulation in audiology training programs, especially for complex clinical skills. It also emphasizes the need for additional research that can be useful in the design and implementation of simulation-based exercises.

An Evaluation of Simulation Techniques in Audiology and Allied Health Professions.

Purpose This study aims to investigate the experiences and opinions of clinical educators from various allied health care fields, including audiology, related to the use of simulation as a teaching technique and determine the status of clinical simulation techniques in training audiology graduate students nationwide. Method An interview was conducted with nine faculty members in the College of Health Professions at Towson University to discuss advantages and challenges of incorporating clinical simulation techniques into student learning. A thematic analysis was used to analyze the interview responses. Additionally, a web-based questionnaire was sent to all audiology graduate program directors nationwide, yielding a response rate of 63%. These data were analyzed using descriptive statistics. Results Interview responses revealed a number of benefits and barriers related to simulation use at the graduate level. Benefits included its use as a learning tool, a quality control measure, and an aid in professional development. It also increases students' confidence levels in clinical procedures and counseling skills and exposes them to a variety of clinical pathologies not routinely seen. Barriers included lack of training with simulators, lack of funding to purchase simulator technology, and lack of resources, such as time and space. At present, only 50% of audiology program directors reported using clinical simulation to train their students. Conclusions The field of audiology is embracing simulation techniques in training its preprofessional work force. To date, there has been limited guidance from professional organizations regarding the role of simulation in audiology. Additional assistance focusing on best practices for these techniques is warranted.

Improving access to community-based pulmonary rehabilitation: 3R protocol for real-world settings with cost-benefit analysis.

BACKGROUND: Pulmonary rehabilitation (PR) has demonstrated patients' physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. METHODS: A 12-week community-based PR will be implemented in primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers (dyads patient-caregivers) will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea (modified Medical Research Council Questionnaire), fatigue (Checklist of individual strength and Functional assessment of chronic illness therapy - fatigue), cough and sputum (Leicester cough questionnaire and Cough and sputum assessment questionnaire), impact of the disease (COPD Assessment Test), emotional state (The Hospital Anxiety and Depression Scale), number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion (Family Adaptation and Cohesion Scale). Other clinical outcomes will be peripheral (biceps and quadriceps-hand held dynamometer, 1 or 10 repetition-maximum) and respiratory (maximal inspiratory and expiratory pressures) muscle strength, muscle thickness and cross sectional area (biceps brachialis, rectus femoris and diaphragm-ultrasound imaging), exercise capacity (six-minute walk test and one-minute sit to stand test), balance (brief-balance evaluation systems test) and physical activity (accelerometer). Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted. DISCUSSION: This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. TRIAL REGISTRATION: The trial was registered in the ClinicalTrials.gov U.S. National Library of Medicine, on 10th January, 2019 (registration number: NCT03799666 ).