Assessing the effectiveness of Compare Assistant for improving intra-rater reliability of ultrasound-measured muscle thickness.

PURPOSE: Muscle thickness measured via ultrasound is commonly used to assess muscle size. The purpose of this study was to determine if the reliability of this measurement will improve if using the Compare Assistant tool, and whether this depends on technician experience and the muscle being assessed. METHODS: Individuals came to the laboratory for two visits each separated by 24 h. On day 1, two ultrasound images were taken on the individual's anterior upper arm (elbow flexors) and anterior lower leg (tibialis anterior) by two inexperienced and one experienced ultrasound technician. On day 2, three images were taken: (1) without looking at the previous images taken on day 1; (2) after re-examining the images taken on day 1, and (3) side-by-side with the images taken on day 1 via Compare Assistant. Bayes Factors (BF10) were used to provide evidence for the null (< 0.33) or alternative (> 3) hypotheses. RESULTS: There was no rater by measurement technique interaction (upper body: BF10 = 0.04, lower body: BF10 = 0.138), nor was there a main effect of measurement technique (upper body: BF10 = 0.052, lower body: BF10 = 0.331), indicating that reliability measures were not improved for either the upper body (CV%, no look: 2.92 vs. Compare Assistant: 2.87) or lower body (CV%, no look: 1.81 vs. Compare Assistant: 1.34) as a result of using Compare Assistant. CONCLUSION: The results of this study suggest that day-to-day reliability of muscle thickness measurement may be limited by random biological variability as opposed to technician error.

A systematic review examining if blood flow restriction can enhance the effectiveness of electrical stimulations.

INTRODUCTION: The use of blood flow restriction (BFR) has been shown to promote greater increases in muscle size and strength when applied during low intensity aerobic exercise and low load resistance exercise. Whether BFR can enhance the effectiveness of E-STIM has been less explored and is the purpose of this study. EVIDENCE ACQUISITION: The databases of Pubmed, Scopus, and Web of Science were searched using the following search: "blood flow restriction" OR "occlusion training" OR "KAATSU" AND "electrical stimulation" OR "E-STIM" OR "neuromuscular electrical stimulation" OR "NMES" OR "electromyostimulation." A three-level random effects restricted maximum likelihood model was computed. EVIDENCE SYNTHESIS: Four studies met the inclusion criteria. There was no additive effect of performing E-STIM under BFR when compared to E-STIM in the absence of BFR [ES: 0.88 (95% CI: -0.28, 2.05); P=0.13]. There was a greater increase in strength when E-STIM was performed under BFR as compared to the same protocol without BFR [ES: 0.88 (95% CI: 0.21, 1.54); P=0.01]. CONCLUSIONS: The lack of effectiveness for BFR to enhance muscle growth may be related to the non-orderly recruitment of motor units when performing E-STIM. The ability of BFR to augment increases in strength may also allow individuals to utilize lower amplitudes to reduce participant discomfort.

Investigating the effects of tic suppression on premonitory urge ratings in children and adolescents with Tourette's syndrome.

Tics represent a complex class of behaviors that have a neurobiological origin and are influenced by factors both internal and external to the individual. One factor that has gained recent attention is the premonitory urge. Contemporary behavioral models suggest that some tics are preceded by aversive somatic urges that increase in severity when tics are suppressed and are attenuated by performance of the tic. It has been proposed that the removal of premonitory urges may strengthen or maintain tics via negative reinforcement. This investigation is the first to empirically evaluate the effect of tic suppression on the premonitory urge phenomenon. Five children and adolescents, ages 8-17years, participated in the study. Using an ABAB reversal design, tic frequency and subjective premonitory urge ratings were recorded under conditions of free-to-tic baseline (BL) and reinforced tic suppression (differential reinforcement of zero-rate behavior). Results show that four of the five children demonstrated reliable suppression. Of the four children who achieved suppression, three demonstrated a pattern in which subjective urge ratings were higher during suppression than during BL. Results provide preliminary support for the negative reinforcement view of tic function for some children.