Perturbations during Gait: A Systematic Review of Methodologies and Outcomes.

BACKGROUND: Despite extensive literature regarding laboratory-based balance perturbations, there is no up-to-date systematic review of methods. This systematic review aimed to assess current perturbation methods and outcome variables used to report participant biomechanical responses during walking. METHODS: Web of Science, CINAHL, and PubMed online databases were searched, for records from 2015, the last search was on 30th of May 2022. Studies were included where participants were 18+ years, with or without clinical conditions, conducted in non-hospital settings. Reviews were excluded. Participant descriptive, perturbation method, outcome variables and results were extracted and summarised. Bias was assessed using the Appraisal tool for Cross-sectional Studies risk of bias assessment tool. Qualitative analysis was performed as the review aimed to investigate methods used to apply perturbations. RESULTS: 644 records were identified and 33 studies were included, totaling 779 participants. The most frequent method of balance perturbation during gait was by means of a treadmill translation. The most frequent outcome variable collected was participant step width, closely followed by step length. Most studies reported at least one spatiotemporal outcome variable. All included studies showed some risk of bias, generally related to reporting of sampling approaches. Large variations in perturbation type, duration and intensity and outcome variables were reported. CONCLUSIONS: This review shows the wide variety of published laboratory perturbation methods. Moreover, it demonstrates the significant impact on outcome measures of a study based on the type of perturbation used. REGISTRATION: PROSPERO ID: CRD42020211876.

3D dentofacial photogrammetry reference values: a novel approach to orthodontic diagnosis.

Background: Orthodontic diagnostic standards generally use the cranial base as a reference and rely on samples selected by orthodontists. Objective: The purpose of this study was to provide male and female standards for a novel non-radiographic approach for orthodontic diagnosis that utilizes 3D dentofacial photogrammetry using the eyes and natural head orientation as references instead of the cranial base. Methods: One hundred and eighty females and 200 males between the ages of 18 and 35 years from 2 modeling agencies were orthodontically screened for near ideal occlusion. Subjects that met the inclusion criteria were rated by a sample of 40 lay people for attractiveness on a visual analogue scale. The final sample that had 3D facial and dental imaging included 49 subjects 25 males and 24 females with near ideal occlusion and considered attractive by the public. Results: Inter and Intra-examiner ICC were greater than 0.8 for both landmarking and indexing. Relative to a coronal plane contacting the pupils (MC), the mean sagittal position of the alar curvature (representing the nasomaxillary complex) was 14.36 ± 3.08 mm in males and 12.4 ± 3.58 mm in females. The sagittal position of soft tissue pogonion relative to the pupils was 14.84 ± 3.63 mm in males and 12.78 ± 5.68 mm in females. The angle between the alar curvature and pogonion relative to the pupils was 9° in males and 10° in females. With the exception of the occlusal plane which was steeper in females, no ratios or angular facial measurements showed a significant gender difference. Relative to MC, males had more proclined upper incisors (20° vs 16°) and more retroclined Lower incisors (27° vs 31°; P > 0.05). A Procrustes ANOVA and permutation test showed that the shapes of males and females are different enough to be considered two distinct populations. Conclusions: 1. When using the proposed method for orthodontic diagnosis, male and female patients should be compared to their respective dentofacial standards. 2. Validation of the proposed method and standards on an orthodontic population is underway to determine the scope its use.

Rural immersion as an instructional method in northern community health.

In 2004, a class of six students traveled with three faculty mentors to seven Alaska communities as part of a course designed to ground young researchers' aspirations in the pragmatics of collaborative, community-based research. This paper, authored by the students involved, discusses the process from start to finish. Beginning researchers in rural health are often daunted not by a lack of ability or ideas, but by basic issues of logistics, trust and respect. Unfortunately, they tend to remain unacquainted with these considerations until something goes wrong, and come to frame the research process as a succession of hindrances to be overcome rather than a fluid and collaborative endeavor. By placing students in working relationships with rural residents and Native elders at an early stage, the project aims to minimize common missteps and shorten the learning curve. It is hoped that our experiences can point the way toward similar efforts.