Digital Health Equity and Tailored Health Care Service for People With Disability: User-Centered Design and Usability Study.

BACKGROUND: As digital health services advance, digital health equity has become a significant concern. However, people with disability and older adults still face health management limitations, particularly in the COVID-19 pandemic. An essential area of investigation is proposing a patient-centered design strategy that uses patient-generated health data (PGHD) to facilitate optimal communication with caregivers and health care service providers. OBJECTIVE: This study aims to conceptualize, develop, and validate a digitally integrated health care service platform for people with disability, caregivers, and health care professionals, using Internet of Things devices and PGHD to contribute to improving digital health equity. METHODS: The methodology consists of 5 stages. First, a collaborative review of the previous app, Daily Healthcare 1.0, was conducted with individuals with disabilities, caregivers, and health care professionals. Secondly, user needs were identified via personas, scenarios, and user interface sketches to shape a user-centered service design. The third stage created an enhanced app that integrated these specifications. In the fourth stage, heuristic evaluations by clinical and app experts paved the way for Daily Healthcare 2.0, now featuring Internet of Things device integration. Conclusively, in the fifth stage, an extensive 2-month usability evaluation was executed with user groups comprising individuals with disabilities using the app and their caregivers. RESULTS: Among the participants, "disability welfare information and related institutional linkage" was the highest priority. Three of the 14 user interface sketches the participants created were related to "providing educational content." The 11 heuristic evaluation experts identified "focusing on a single task" as a crucial issue and advocated redesigning the home menu to simplify it and integrate detailed menus. Subsequently, the app Daily Healthcare 2.0 was developed, incorporating wearable devices for collecting PGHD and connecting individuals with disabilities, caregivers, and health care professionals. After the 2-month usability evaluation with 27 participants, all participants showed an increase in eHealth literacy, particularly those who used the caregiver app. Relatively older users demonstrated improved scores in health IT usability and smartphone self-efficacy. All users' satisfaction and willingness to recommend increased, although their willingness to pay decreased. CONCLUSIONS: In this study, we underscore the significance of incorporating the distinct needs of individuals with disabilities, caregivers, and health care professionals from the design phase of a digital health care service, highlighting its potential to advance digital health equity. Our findings also elucidate the potential benefits of fostering partnerships between health consumers and providers, thereby attenuating the vulnerability of marginalized groups, even amid crises such as the COVID-19 pandemic. Emphasizing this imperative, we advocate for sustained endeavors to bolster the digital literacy of individuals with disabilities and champion collaborative cocreation, aiming to uphold the collective ethos of health and digital health equity.

Tai chi-muscle power training for children with developmental coordination disorder: a randomized controlled trial.

This study compared the effectiveness of tai chi (TC) muscle power training (MPT), TC alone, MPT alone, and no training for improving the limits of stability (LOS) and motor and leg muscular performance and decreasing falls in children with developmental coordination disorder (DCD). One hundred and twenty-one children with DCD were randomly assigned to the TC-MPT, TC, MPT, or control group. The three intervention groups received TC-MPT, TC, or MPT three times per week for 3 months. Measurements were taken before and after the intervention period. The primary outcomes were the LOS completion time and dynamic LOS scores. The secondary outcomes included the Movement Assessment Battery for Children-Second Edition total test score and percentile rank, knee muscle peak force and time to peak force, and the number of falls. None of the interventions affected the LOS test scores. Improvements in the peak forces of the knee extensors and flexors were demonstrated in the TC (p = 0.006) and MPT groups (p = 0.032), respectively. The number of falls also decreased in these two groups (p < 0.001). Thus, clinicians may prescribe TC or MPT for children with DCD to increase their knee muscle strength and reduce their risk of falls.

Effects of kinesiology taping on shoulder girdle muscle activity and sports performance during badminton forehand overhead strokes in amateur badminton players with shoulder impingement syndrome.

BACKGROUND: This study aimed to examine the influence of kinesiology taping (KT), various overhead stroke techniques, and their interactions on shoulder girdle muscle activity and on sports performance in badminton players with shoulder impingement syndrome. METHODS: Twenty-five amateur badminton players with shoulder impingement syndrome participated in the study. Each was exposed to two KT conditions (no taping and taping) while performing four badminton strokes (defensive clear, attacking clear, smash, and drop shot) in a random order. Surface electromyography (EMG) was used to evaluate the activity of the pectoralis major, anterior deltoid, infraspinatus, and latissimus dorsi muscles. The EMG data are expressed as a percentage of the EMG amplitude recorded during a maximal voluntary isometric contraction of the respective muscles. The shuttlecock speed was also measured via video analysis. RESULTS: The pectoralis major, anterior deltoid, infraspinatus, and latissimus dorsi EMG amplitudes were greatest during smashes (P<0.05), followed in general by attacking clearances (P<0.05) and defensive clearances (P<0.05). Drop shots induced the lowest EMG amplitudes in the shoulder girdle muscles (P<0.05). No significant main effect of the KT condition or KT-badminton stroke interaction effects were found (P>0.05). CONCLUSIONS: The use of KT conferred no immediate benefits in improving shoulder girdle muscle activity or sports performance in amateur badminton players with shoulder impingement syndrome. Shoulder girdle muscle activity and sports performance were primarily influenced by the badminton overhead stroke techniques.

Adapted Taekwondo Training for Prepubertal Children with Developmental Coordination Disorder: A Randomized, Controlled Trial.

This study evaluated the effectiveness of adapted Taekwondo (TKD) training on skeletal development and motor performance in children with developmental coordination disorder (DCD). One hundred forty-five prepubertal children with DCD were allocated to either the TKD or control groups. Children in the TKD group participated in a weekly 1-hour adapted TKD intervention and daily TKD home exercises for 12 weeks. The primary outcome (delay in skeletal development) and secondary outcomes (Movement Assessment Battery for Children (MABC) total impairment score, eye-hand coordination (EHC) scores, and a standing balance score) were measured at baseline, after the intervention and 3 months after the intervention. Skeletal development improved in both groups over time (p < 0.017). The TKD group had a significant delay in skeletal development at baseline compared to the control group (p = 0.003) but caught up with the controls at 3 months (p = 0.041). Improvements in the MABC scores were also seen in both groups across time (p < 0.017). Only the TKD group had a significant improvement in the EHC movement time at 3 (p = 0.009) and 6 months (p = 0.016). The adapted TKD intervention may be effective in improving the skeletal development and EHC movement time of children with DCD. For motor performance, the effect of maturation might be more profound.

Influence of pelvic padding and Kinesiology Taping on pain perception, kinematics, and kinetics of falls in female volleyball athletes.

BACKGROUND: Volleyball digging techniques may cause pelvic injuries among female volleyball athletes. Pelvic padding and Kinesiology Taping (KT) may reduce impact force and pain and improve posture during a fall. This study examined the effects of pelvic padding and KT on pain perception, fall kinematics, and kinetics among female volleyball athletes. METHODS: Twenty-four female volleyball athletes were exposed to two pelvic padding scenarios (with and without padding) and two KT conditions (with and without KT applied on the rectus abdominis muscle) during a fall in the forward direction. The maximum impact force during landing and maximum acceleration of the pelvis were registered using a force platform and an accelerometer, respectively. The maximum lumbar (hyper) extension angle, forward reach distance, and total fall time were measured by video analysis. Pain level was quantified using a visual analog scale. RESULTS: The application of pelvic padding (with and without KT) reduced pain when compared to the no padding condition (p < 0.008). Applying KT alone reduced forward reach distance when compared to the 'pelvic padding and KT' condition (p < 0.010). In fact, when both pelvic padding and KT were applied, participants reached further when compared to the 'no pelvic padding and no KT' condition (p < 0.001). No significant main and interaction effects were found in all other outcomes. CONCLUSIONS: Volleyball shorts with pelvic pads are recommended for female volleyball athletes to reduce pain in the digging maneuver and may help to increase their forward reach distance. However, KT is not recommended as it reduces the forward reach distance and cannot reduce pain or improve fall kinematics and kinetics.

Acute Effects of Tai Chi Training on Cognitive and Cardiovascular Responses in Late Middle-Aged Adults: A Pilot Study.

This study explored the immediate effects of Tai Chi (TC) training on attention and meditation, perceived stress level, heart rate, oxygen saturation level in blood, and palmar skin temperature in late middle-aged adults. Twenty TC practitioners and 20 nonpractitioners volunteered to join the study. After baseline measurements were taken, the TC group performed TC for 10 minutes while their cognitive states and cardiovascular responses were concurrently monitored. The control group rested for the same duration in a standing position. Both groups were then reassessed. The participants' attention and meditation levels were measured using electroencephalography; stress levels were measured using Perceived Stress Scale; heart rate and blood oxygenation were measured using an oximeter; and palmar skin temperature was measured using an infrared thermometer. Attention level tended to increase during TC and dropped immediately thereafter (p < 0.001). Perceived stress level decreased from baseline to posttest in exclusively the TC group (p = 0.005). Heart rate increased during TC (p < 0.001) and decreased thereafter (p = 0.001). No significant group, time, or group-by-time interaction effects were found in the meditation level, palmar skin temperature, and blood oxygenation outcomes. While a 10-minute TC training could temporarily improve attention and decrease perceived stress levels, it could not improve meditation, palmar skin temperature, or blood oxygenation among late middle-aged adults.

Musculoskeletal profile of middle-aged Ving Tsun Chinese martial art practitioners: A cross-sectional study.

This cross-sectional exploratory study aimed to quantify and compare the axial and appendicular bone mineral density (BMD), muscle mass, and muscle strength of middle-aged practitioners of Ving Tsun (VT; a hard-style Chinese martial art) with those of nonpractitioners.Eighteen VT practitioners (mean age ±â€Šstandard deviation = 51.8 ±â€Š17.7 years; 12 men and six women) and 36 active controls (mean age ±â€Šstandard deviation = 58.7 ±â€Š11.0 years; 18 men and 18 women) participated in the study. All participants underwent a 1-day battery of musculoskeletal examinations. The BMD of the total radius, total hip, femoral neck, and lumbar spine was measured using dual-energy X-ray absorptiometry, as was the lean mass of the arm, leg, and trunk. Muscle strength of the upper and lower limbs was assessed using a Jamar dynamometer and an isokinetic dynamometer at 60°/second, respectively.VT-trained participants had a 11.5% higher total radius BMD (P = 0.023), a 17.8% higher leg lean mass (P = 0.014), a 56.4% higher isokinetic body weight-adjusted peak torque of the knee extensors (P < 0.001), a 60.8% higher isokinetic body weight-adjusted peak torque of knee flexors (P < 0.001), and a 31.4% shorter time to reach peak torque in the knee flexors (P = 0.001) than the active controls. No significant differences were found in any of the other musculoskeletal outcomes between the 2 groups (P > 0.05).Middle-aged VT practitioners displayed a higher total radius BMD and leg lean mass and better knee extensor and flexor muscular performances than their healthy active counterparts. Healthcare professionals may consider using this alternative method of training to improve the musculoskeletal health of middle-aged adults.

An efficacy study on improving balance and gait in subacute stroke patients by balance training with additional motor imagery: a pilot study.

[Purpose] The few studies conducted on subacute stroke patients have focused only on gait function improvement. This study therefore aimed to confirm the effect of balance training with additional motor imagery on balance and gait improvement in subacute stroke patients. [Subjects and Methods] Participants were divided into an experimental or control group. The experimental group received balance training for 20 minutes/day with mental imagery for 10 minutes/day, three days/week, for four weeks. The control group received only balance training for 30 minutes. Before and after the 12 sessions, balance and gait ability were assessed by the researcher and a physical therapist. [Results] After completion of the 4-week intervention, Berg Balance Scale, Timed Up and Go test, Functional Reach Test, and Four Square Step test scores significantly increased in the experimental group. In the control group, Berg Balance Scale and Functional Reach Test scores significantly improved. Changes in the Timed Up and Go test, Functional Reach Test, and Four Square Step Test scores after intervention were significantly higher in the experimental than in the control group. [Conclusion] Specific balance training with additional motor imagery may result in better rehabilitation outcomes of gait and balance ability than balance training alone.

Effects of Lower-Leg Kinesiology Taping on Balance Ability in Stroke Patients with Foot Drop.

Objective. The purpose of this study was to observe the effects of lower-leg kinesiology taping on balance ability in stroke patients with foot drop. Design. Randomized controlled trial study. Method. Thirty stroke patients with foot drop were randomly divided into two groups. The experimental group underwent kinesiology taping, and the control group underwent placebo taping. Balance ability was assessed before and after taping in both groups. Results. No difference was observed over time in the Berg Balance Scale score between the two groups, and a significant difference in the Berg Balance Scale score was observed only in the experimental group. Additionally, there were significant differences in the center of pressure area and limits of stability over time. Conclusion. Kinesiology taping temporarily improved static balance ability in stroke patients. However, its effect on dynamic balance was not verified. Therefore, further research on the influence of long-term kinesiology taping on dynamic balance and gait ability is suggested.

Immediate Effects of Kinesiology Taping of Quadriceps on Motor Performance after Muscle Fatigued Induction.

Objectives. The purpose of this cross-sectional single-blind study was to investigate the immediate effects of Kinesiology taping of quadriceps on motor performance after muscle fatigued induction. Design. Randomized controlled cross-sectional design. Subjects. Forty-five subjects participated in this study. Participants were divided into three groups: Kinesiology taping group, placebo taping group, and nontaping group. Methods. Subjects performed short-term exercise for muscle fatigued induction, followed by the application of each intervention. Peak torque test, one-leg single hop test, active joint position sense test, and one-leg static balance test were carried out before and after the intervention. Results. Peak torque and single-leg hopping distance were significantly increased when Kinesiology taping was applied (p < 0.05). But there were no significant effects on active joint position sense and single-leg static balance. Conclusions. We proved that Kinesiology taping is effective in restoring muscle power reduced after muscle fatigued induction. Therefore, we suggest that Kinesiology taping is beneficial for fatigued muscles.

Core Muscle Activity during TRX Suspension Exercises with and without Kinesiology Taping in Adults with Chronic Low Back Pain: Implications for Rehabilitation.

This study aimed to examine the effects of kinesiology taping (KT) and different TRX suspension workouts on the amplitude of electromyographic (EMG) activity in the core muscles among people with chronic low back pain (LBP). Each participant (total n = 21) was exposed to two KT conditions: no taping and taping, while performing four TRX suspension exercises: (1) hamstring curl, (2) hip abduction in plank, (3) chest press, and (4) 45-degree row. Right transversus abdominis/internal oblique (TrAIO), rectus abdominis (RA), external oblique (EO), and superficial lumbar multifidus (LMF) activity was recorded with surface EMG and expressed as a percentage of the EMG amplitude recorded during a maximal voluntary isometric contraction of the respective muscles. Hip abduction in plank increased TrAIO, RA, and LMF EMG amplitude compared with other TRX positions (P < 0.008). Only the hamstring curl was effective in inducing a high EMG amplitude of LMF (P < 0.001). No significant difference in EMG magnitude was found between the taping and no taping conditions overall (P > 0.05). Hip abduction in plank most effectively activated abdominal muscles, whereas the hamstring curl most effectively activated the paraspinal muscles. Applying KT conferred no immediate benefits in improving the core muscle activation during TRX training in adults with chronic LBP.