Using represented bodies in Renaissance artworks to teach musculoskeletal and surface anatomy.

Surface anatomy is an important skill for students in preparation for patient care, and peer examination is often used to teach musculoskeletal and surface anatomy. An alternative pedagogical approach is to use bodies represented in artworks. Represented bodies display fictive anatomy, providing students with the opportunity to apply their musculoskeletal knowledge and to think critically when evaluating the anatomical fidelity of a represented body. An elective course at the University of Michigan enabled undergraduate students to analyze the musculoskeletal and surface anatomy depicted in Renaissance artworks. Students traveled to Italy in 2018 (n = 14) and 2022 (n = 15) to analyze the fictive anatomy portrayed in artistic sculptures and musculoskeletal structures depicted in wax anatomy models and sculpted skeletons. In assignments, students were asked to identify musculoskeletal structures as portrayed in the context of represented anatomy created by Italian Renaissance artists and to assess the fidelity of the depicted anatomy. The students also applied their knowledge of musculoskeletal anatomy to describe body position and evaluate muscle function in their assessments of the accuracy or inaccuracy of the fictive anatomy. The students reported that evaluating the anatomical fidelity of represented bodies in artworks supported their learning of musculoskeletal and surface anatomy, and that their critical thinking skills improved in the course. Evaluation of the anatomical fidelity of represented bodies in artworks is an effective pedagogical approach that can be implemented in art museums as an adjunctive learning experience to deepen students' musculoskeletal and surface anatomy knowledge and further develop their critical thinking skills.

The effect of mood phases on balance control in bipolar disorder.

The aim of this study was to investigate balance control during gait and sit-to-walk in individuals with bipolar disorder and healthy controls by examining the inclination angles between the whole-body center-of-mass (COM) and ankle in the sagittal plane. Twenty-one individuals with bipolar disorder in the euthymic (i.e., asymptomatic; n = 11) and depressed (n = 10) phases and 7 healthy controls (ages between 18 and 45) performed gait and sit-to-walk at self-selected comfortable speed. Mood phases for individuals with bipolar disorder were measured using the Patient Health Questionnaire and Altman Self-Rating Mania Scale. We collected motion data using a 16-camera motion capture technology. We found smaller COM-ankle inclination angles at seat-off during sit-to-walk for the bipolar-depressed group compared to the bipolar-euthymic and healthy groups, indicating poorly controlled balance for the bipolar-depressed group in sit-to-walk. However, we found larger COM-ankle inclination angles at beginning of single stance phase of gait for the bipolar-euthymic group compared to the healthy group, indicating well controlled balance for the bipolar-euthymic group in gait. Our results suggest an association between the depressed phase and balance impairment during daily movements in relatively young adults (ages ≤ 45 years). Our results also suggest that the depressed phase may be as detrimental to balance control as the effect of age-related neuromuscular weakness.

Motor behavior characteristics in various phases of bipolar disorder revealed through biomechanical analysis: Quantitative measures of activity and energy variables during gait and sit-to-walk.

Abnormal motor behaviors influenced by high or low energy states are key signs and symptoms for mania/hypomania or depression, respectively. Clinical evaluation is currently based on qualitative, subjective self-reports. We aimed to objectively quantify activity and energy variables during gait and sit-to-walk in bipolar disorder. Gait and sit-to-walk were analyzed in 31 individuals with bipolar disorder (five hypomanic, 14 euthymic and 12 depressed) and 14 healthy controls using a motion capture system and two force platforms. The 9-item Patient Health Questionnaire and Altman Self Rating Mania Scale were administered to evaluate mood symptoms. During gait and sit-to-walk, the hypomanic group had 20-30% greater movement speed and produced 10-60% greater peak force, and 40-140% greater peak power in the knee or ankle compared to the euthymic, depressed and healthy groups. Biomechanical measures of activity and energy correlated with clinically defined hypomania. Our findings suggest that movement speed and force production could serve as objective activity and energy markers for hypomanic symptoms in individuals with bipolar disorder, but this study was based on a relatively small sample size, and the laboratory-based assessments are not directly transferable to a clinical setting.

Effects of image-based and text-based active learning exercises on student examination performance in a musculoskeletal anatomy course.

Research on the benefits of visual learning has relied primarily on lecture-based pedagogy, but the potential benefits of combining active learning strategies with visual and verbal materials on learning anatomy has not yet been explored. In this study, the differential effects of text-based and image-based active learning exercises on examination performance were investigated in a functional anatomy course. Each class session was punctuated with an average of 12 text-based and image-based active learning exercises. Participation data from 231 students were compared with their examination performance on 262 questions associated with the in-class exercises. Students also rated the helpfulness and difficulty of the in-class exercises on a survey. Participation in the active learning exercises was positively correlated with examination performance (r = 0.63, P < 0.001). When controlling for other key demographics (gender, underrepresented minority status) and prior grade point average, participation in the image-based exercises was significantly correlated with performance on examination questions associated with image-based exercises (P < 0.001) and text-based exercises (P < 0.01), while participation in text-based exercises was not. Additionally, students reported that the active learning exercises were helpful for seeing images of key ideas (94%) and clarifying key course concepts (80%), and that the image-based exercises were significantly less demanding, less hard and required less effort than text-based exercises (P < 0.05). The findings confirm the positive effect of using images and active learning strategies on student learning, and suggest that integrating them may be especially beneficial for learning anatomy. Anat Sci Educ 10: 444-455. © 2017 American Association of Anatomists.

The effect of emotion on movement smoothness during gait in healthy young adults.

This study aimed to investigate the effect of emotion on movement smoothness during gait. We followed an autobiographical memories paradigm to induce four target emotions, neutral emotion, sadness, anger and joy, in eighteen healthy young adults. Participants performed gait trials while feeling the target emotions. We collected gait data using an eight-camera optoelectronic motion capture system. We measured spatiotemporal gait parameters, smoothness of linear movements for the whole body center-of-mass (COM), head, thorax and pelvis in the anterior-posterior (AP), vertical (VT) and mediolateral (ML) directions, and smoothness of angular movements in the sagittal plane for the shoulder, elbow, wrist, hip, knee and ankle. Movement smoothness was measured as jerk, the first time derivative to acceleration, normalized to movement distance and stride time. Compared to sadness, gait speed increased with anger and joy, and spatiotemporal parameters associated with increased gait speed changed accordingly. In the VT direction, movement smoothness in the whole body COM, head, thorax and pelvis increased for anger and joy compared to sadness. In the AP direction, movement smoothness increased only for the head for neutral emotion, anger and joy compared to sadness. In the ML direction, emotion did not affect movement smoothness. In angular movements, smoothness in the hip and ankle increased for anger compared to sadness. Smoothness in the shoulder increased for anger and joy compared to sadness. The present findings suggest that emotion affects movement smoothness during gait, and that anger and joy are associated with increased movement smoothness.

Emotional influences on sit-to-walk in healthy young adults.

The purpose of this study was to investigate influences of emotional feelings on sit-to-walk (STW). Eighteen healthy young adults performed STW while feeling sadness, anger, joy and neutral emotion. Emotions were elicited using an autobiographical memories task. We used an optoelectronic motion capture system to collect motion data and assessed kinematics of STW. Emotion-related differences in STW kinematics were consistent with differences in movement speed. Compared to neutral emotion, sadness was associated with increased STW duration and phase durations, decreased peak forward and vertical center-of-mass (COM) velocity, increased drop in forward COM velocity, and increased forward and vertical normalized jerk score (NJS). Anger and joy were associated with decreased STW duration and phase durations, increased peak forward and vertical COM velocity, decreased drop in forward COM velocity, and decreased forward and vertical NJS compared to neutral emotion. Findings suggest that emotional feelings affect movement speed, hesitation, and movement smoothness during STW.

Effort-Shape and kinematic assessment of bodily expression of emotion during gait.

The purpose of this study was to identify the movement characteristics associated with positive and negative emotions experienced during walking. Joy, contentment, anger, sadness, and neutral were elicited in 16 individuals, and motion capture data were collected as they walked while experiencing the emotions. Observers decoded the target emotions from side and front view videos of the walking trials; other observers viewed the same videos to rate the qualitative movement features using an Effort-Shape analysis. Kinematic analysis was used to quantify body posture and limb movements during walking with the different emotions. View did not affect decoding accuracy except for contentment, which was slightly enhanced with the front view. Walking speed was fastest for joy and anger, and slowest for sadness. Although walking speed may have accounted for increased amplitude of hip, shoulder, elbow, pelvis and trunk motion for anger and joy compared to sadness, neck and thoracic flexion with sadness, and trunk extension and shoulder depression with joy were independent of gait speed. More differences among emotions occurred with the Effort-Shape rather than the kinematic analysis, suggesting that observer judgments of Effort-Shape characteristics were more sensitive than the kinematic outcomes to differences among emotions.