Accurate Prediction of Knee Angles during Open-Chain Rehabilitation Exercises Using a Wearable Array of Nanocomposite Stretch Sensors.

In this work, a knee sleeve is presented for application in physical therapy applications relating to knee rehabilitation. The device is instrumented with sixteen piezoresistive sensors to measure knee angles during exercise, and can support at-home rehabilitation methods. The development of the device is presented. Testing was performed on eighteen subjects, and knee angles were predicted using a machine learning regressor. Subject-specific and device-specific models are analyzed and presented. Subject-specific models average root mean square errors of 7.6 and 1.8 degrees for flexion/extension and internal/external rotation, respectively. Device-specific models average root mean square errors of 12.6 and 3.5 degrees for flexion/extension and internal/external rotation, respectively. The device presented in this work proved to be a repeatable, reusable, low-cost device that can adequately model the knee's flexion/extension and internal/external rotation angles for rehabilitation purposes.

Veteran Suicide Risk Factors: A National Sample of Nonveteran and Veteran Men Who Died by Suicide.

Veteran suicide is a serious public health problem. Some data suggest that veteran suicide risk profiles differ from those of nonveterans. Records for veteran (n = 21,692) and nonveteran (n = 83,430) men who died by suicide were examined from 17 U.S. states using the National Violent Death Reporting System data. Seventeen precipitating factors were examined and combined through meta-analysis of proportions. Many precipitating factors were found to be less frequent for veterans. A smaller number of factors were found to be higher in the veteran population, including physical health problems. A sizable cumulative effect size (1.02) was observed, suggesting that veteran and nonveteran men show meaningful and substantive differences in their risk profiles-differences that should be considered when planning and implementing suicide prevention and intervention efforts. The conspicuous role of physical health problems among veterans who die by suicide is discussed. The article concludes with specific practice recommendations for social workers.

TRR's Warrior Camp: An Intensive Treatment Program for Combat Trauma in Active Military and Veterans of All Eras.

Effective treatments for combat trauma in military service members exist, but barriers to care abound, including poor access, stigma, and dropout. Although the effects of post-traumatic stress disorder (PTSD) can be severe, recovery is possible when proper treatment is implemented. Trauma and Resiliency Resources, Inc.'s Warrior Camp (WC) program is designed to address the effects of combat trauma in military service members and veterans. This intensive, 7-d treatment incorporates eye movement desensitization and reprocessing therapy, equine-assisted psychotherapy, yoga, and narrative writing in context of community. This single-group pretest-posttest design included paired t-tests and effect size analyses for 85 participants of WC. Outcome measures included the Mississippi Scale for Combat-related PTSD, the Patient Health Questionnaire, the Revised Adult Attachment Scales, and the Moral Injury Events Scale. Clinician-administered measures included the Davidson Trauma Scale and the Dissociative Experiences Scale. All measures showed statistically significant reductions in distress. The effect sizes ranged from small to large. Results suggest that WC participants experienced significant improvement in PTSD, depression, moral injury, dissociation and adult attachment. Clinicians should consider the potential benefits of this short-term, intensive treatment when addressing combat-related PTSD among military service members and veterans.

Sexual Assault Prevention Efforts in the U.S. Air Force: A Systematic Review and Content Analysis.

The issue of sexual assault in the U.S. military is problematic and prevalent. All military branches have undertaken an effort to develop and implement sexual assault prevention programs (SAPPs), yet these programs lack a rigorous and independent evaluation process, limiting an understanding of effectiveness. We examined the four official SAPPs that have been used within the U.S. Air Force (USAF) over the past decade by comparing their content and process with best practice suggestions for SAPPs. Content of the four USAF SAPPs was evaluated on 47 different criteria grouped into the following program elements: content, process, and outcome. Independent ratings of the criteria were reliable, and results indicated strengths and opportunities for improvement. Most notably, evidence of an objective program evaluation system is lacking. Recommendations for improving SAPPs are offered.

Mechanisms of Action Contributing to Reductions in Suicide Attempts Following Brief Cognitive Behavioral Therapy for Military Personnel: A Test of the Interpersonal-Psychological Theory of Suicide.

Brief cognitive behavioral therapy (BCBT) is associated with significant reductions in suicide attempts among military personnel. However, the underlying mechanisms of action contributing to reductions in suicide attempts in effective psychological treatments remain largely unknown. The present study conducted a secondary analysis of a randomized controlled trial of BCBT versus treatment as usual (TAU) to examine the mechanisms of action hypothesized by the interpersonal-psychological theory of suicide (IPT): perceived burdensomeness, thwarted belongingness, and fearlessness about death. In a sample of 152 active duty U.S. Army personnel with recent suicide ideation or attempts, there were significantly fewer suicide attempts in BCBT, but there were no differences between treatment groups from baseline to 6 months postbaseline on any of the 3 IPT constructs or their interactions. Tests of the moderated mediation failed to support an indirect effect for the IPT model, regardless of which IPT variables were specified as mediators or moderators. Results suggest that the IPT's hypothesized mechanisms of action do not account for reductions in suicide attempts in BCBT. Implications for clinical practice and research are discussed.

Short-Term Interventions for Survivors of Intimate Partner Violence: A Systematic Review and Meta-Analysis.

Intimate partner violence (IPV) impacts millions of adults and children every year and can result in homicide, legal proceedings, the involvement of child welfare, and the need for emergency shelter for survivors and their families. Survivors of IPV may develop psychological and somatic symptoms to the trauma, including anxiety, depression, and other mental health related disorders in addition to facing numerous safety, financial, and social challenges. To reestablish stability, effective short-term interventions are needed in order to address these issues survivors face. This systematic review and meta-analysis summarizes the extant literature on short-term interventions for survivors of IPV. Twenty-one studies are included in the analysis and overall effect sizes calculations and moderator analysis were conducted. On average, effects sizes were large (g = 1.02) suggesting that most sort-term interventions are effective, however CBT-based interventions that were tailored to IPV survivors achieved the largest effect sizes. Results of this study are presented in a question and answer format with the intent to guide practitioners, researchers and policy makers. IPV survivors access services in a variety of shelter and outpatient settings and present diverse needs. Although this study contributes a systematic review of the existing literature on IPV, there are relatively few rigorous outcome studies and even fewer that reflect the diversity in this population and the complexity of responding to IPV in real-world settings.

Potentiation of concentric force and acceleration only occurs early during the stretch-shortening cycle.

The purpose of this study was to determine where stretch-shortening cycle (SSC) potentiation of force, power, velocity, and acceleration occurs across the concentric phase of ballistic leg presses. Second, we examined the influence of late eccentric phase force and length of the amortization phase on potentiated concentric phase performance variables. Twenty-one male runners (age: 31.9 ± 4.7 years) performed SSC and concentric-only (CO) ballistic leg press throws. Potentiations of concentric actions were calculated as the difference between SSC and CO contractions. An analysis splitting the concentric range of motion (ROM) into 6 equal time intervals determined force and acceleration were potentiated (p < 0.05) only during the first one-sixth time interval of concentric motion, whereas velocity and power were potentiated (p < 0.05) at all time intervals over the entire concentric motion with the exception of power over the last one-sixth time interval. A more precise analysis examining 20-millisecond time intervals across the first 200 milliseconds of concentric motion determined force was potentiated only over the first 140 milliseconds and acceleration only over the first 160 milliseconds. Eccentric force measured during the last 100 milliseconds of eccentric motion was related to potentiated force during the initial 200 milliseconds of concentric motion (r = 0.44, p < 0.05) and potentiated mean power across the full concentric ROM (r = 0.62, p < 0.01). Results indicate that in contrast to power and velocity, potentiation of force and acceleration occurs only early during the concentric phase of SSC ballistic leg presses. Correlational findings imply late eccentric phase force is important for generating force and power during the concentric phase of the SSC and thus training focusing on enhancing late phase eccentric force appears important for developing explosive force and power during SSC movements.

Tendon length and joint flexibility are related to running economy.

PURPOSE: The purpose of study was to determine whether quadriceps/patella and Achilles tendon length and flexibility of the knee extensors and plantar flexors are related to walking and running economy. METHODS: Twenty-one male distance runners were subjects. Quadriceps/patella and Achilles tendon length were measured by magnetic resonance imaging; body composition was measured DXA; oxygen uptake at rest while seated, walking (3 mph), and running (6 and 7 mph) were measured by indirect calorimetry; knee and ankle joint flexibility were measured by goniometry; and leg lengths were measured by anthropometry while seated. Correlations were used to identify relationships between variables of interest. RESULTS: Net VO2 (exercise VO2 - rest VO2) for walking (NVOWK) and running at 6 and 7 mph (NVO6 and NVO7, respectively) was significantly related to Achilles tendon length (r varying from -0.40 to -0.51, P all < 0.04). Achilles tendon cross section was not related to walking or running economy. Quadriceps/patella tendon length was significantly related to NVO7 (r = -0.43, P = 0.03) and approached significance for NVO6 (r = -0.36, P = 0.06). Flexibility of the plantar flexors was related to NVO7 (+0.38, P = 0.05). Multiple regression showed that Achilles tendon length was independently related to NVO6 and NVO7 (partial r varying from -0.53 to -0.64, all P < 0.02) independent of lower leg length, upper leg length, quadriceps/patella tendon length, knee extension flexibility, or plantarflexion flexibility. CONCLUSIONS: These data support the premise that longer lower limb tendons (especially Achilles tendon) and less flexible lower limb joints are associated with improved running economy.