Short-term effects of kinesiology taping on static and dynamic balance in healthy subjects.

Background: As a therapeutic tool, kinesiology taping (KT) has become increasingly popular for musculoskeletal injuries utilized by physiotherapists. KT has been found to have effects on facilitating muscle strength by generating a concentric pull on the fascia. However, little is known about KT in the improvement of dynamic and static balance. This study aims to explore whether KT on the quadriceps muscle has any immediate effects on static and dynamic balance. Methodology: Twenty-seven healthy individuals (13 males and 14 females, aged 22 to 29) were recruited in a crossover study with two conditions: KT and no taping. KT was applied to the quadriceps muscle for the taping group, with the control receiving no taping. Pre- and post-test measurements were taken to give an indication of the effect of the tape on balance performance. Center of Pressure Excursion (COPE) and Time to Stabilization (TTS) when landing from a hop test and Y Balance test combined score (YBTCS) were used to assess a stabilizing balance activity and a dynamic balance. The pre- and post-intervention were collected, with differences explored using repeated measures ANOVA with time and condition (tape) factor analysis. Results: We found a significant improvement (p ≤ 0.05) with a moderate to large effect size in YBTCS between KT and no taping, indicating enhanced balance performance in the KT group. However, no significant difference (p ≥ 0.05) with small to moderate effect size was found in COPE or TTS between the two conditions during landing tests, suggesting similar balance capabilities in these specific measures. Conclusion: The use of KT shows no significant immediate effect on static balance in healthy individuals when applied to the quadriceps muscles; however, it demonstrates a positive immediate effect on dynamic balance.

The Single Hop for Distance Test: Reviewing the Methodology to Measure Maximum and Repeated Performance.

CONTEXT: The single hop for distance (SHD) and Limb Symmetry Index are often used to assess readiness for returning to sport postinjury. However, the sensitivity of SHD Limb Symmetry Index for detecting functional abnormalities is questionable due to the methodological inconsistencies in the literature. The common methods use few repetitions; lacking consideration of repeated maximum performance, or the effect of fatigue (or failed attempts) on repeated maximum performance, required for sport. The objectives were to review the SHD for evaluating repeated maximum performance, and the effect of failed attempts on consistency of performance, in a healthy population of sportspersons. DESIGN: A quantitative, nonexperimental, same-subject, repeated-measures design with 15 healthy Cardiff University students. METHOD: Participants performed the SHD up to 30 times on each limb, with standardized rests. A failed attempt, if the landing was not controlled, was noted but distance not recorded. Participants stopped if 3 consecutive distances decreased, or 30 repetitions were achieved. RESULTS: Average hop distance increased with each repetition. Only the 28th to 30th hops were between the maximum average value and 1 SD below. With failed repetitions included, the maximum average hop was at repetition 21 with more results falling between the maximum and 1 SD below, demonstrating more consistency in repeated performance. The number of failed repetitions had a trend to increase over time; whether subjects overreach in attempt to achieve maximum performance, or whether due to fatigue is unknown. CONCLUSION: Maximum performance of SHD is not achieved until multiple repetitions have been conducted. Repeated maximum performance does not drop-off until over 21 repetitions have been conducted. Consistency of repeated maximum performance varies depending on whether failed attempts are included in the analysis. Further investigation into the reasons for failed attempts is required to improve clinical decision making for return to sport postinjury.

GPs' perceptions of advance care planning with frail and older people: a qualitative study.

BACKGROUND: Frail and older people are estimated to account for 40% of deaths. Despite conversations about end-of-life care being an important component of the national End of Life Care Strategy, there is a marked disparity between the majority who would like to discuss advance care plans, and the minority who currently have this opportunity. AIM: To investigate the attitudes of GPs to advance care planning (ACP) discussions with frail and older individuals. DESIGN AND SETTING: Focus group study with GPs in Cambridgeshire between September 2015 and January 2016. METHOD: Five focus groups with 21 GPs were purposively sampled to maximise diversity. Framework analysis was used to analyse transcripts and develop themes. RESULTS: Although some GPs were concerned it might cause distress, the majority felt that raising ACP was important, especially as preparation for future emergencies. Knowing the individuals, introducing the idea as part of ongoing discussions, and public awareness campaigns were all facilitators identified. Several considered that service limitations made it difficult to fulfil patients' wishes and risked raising unrealistic patient expectations. Other barriers identified included uncertainty over prognosis and difficulties ensuring that individuals' wishes were respected. CONCLUSION: Most GPs viewed ACP as important. However, their enthusiasm was tempered by experience. This study highlights the difficulties for GPs of encouraging dialogue and respecting individuals' wishes within the constraints of the existing health and social care system. National publicity campaigns and encouraging patients to prioritise healthcare outcomes could help GPs raise care preferences without causing a detrimental impact on patients or raising unrealistic expectations. Once patients agree their care preferences, they need to be documented, accessible, and reviewed by all relevant health and social care providers to ensure that their wishes are respected, and plans amended as their circumstances change.

Best practices for storing and shipping cryopreserved cells.

Successfully recovering stored cryopreserved cells requires attention to two major factors, i.e., storage temperature and proper handling of the frozen samples. These key considerations are in turn impacted by how the inventory system is constructed, the frequency and process for retrieving specimens, as well as how the material is secured. In addition, shipping biological materials requires attention to the type of material transported, adherence to regulatory requirements, packaging materials and proper assembly, labeling, and engaging reputable carriers. This paper provides an overview discussion of the current best practices for storing, handling, and shipping of cryopreserved cells and provides references to more detailed information on specific topics.

Do the elderly have a voice? Advance care planning discussions with frail and older individuals: a systematic literature review and narrative synthesis.

BACKGROUND: Recent years have seen marked improvements in end-of-life care, however concerns have been expressed that services are focused on the needs of patients with cancer. This review focuses on conversations about end-of-life care with frail and older people who have no main overriding diagnosis who are estimated to account for around 40% of deaths. AIM: To investigate the attitudes of the public and healthcare professionals to advance care planning discussions with frail and older people. DESIGN AND SETTING: Systematic literature review and narrative synthesis. METHOD: Articles that related to frail or older individuals and either advance care plans or discussions on end-of-life care were included. Studies of specific conditions or that focused on prognosis, capacity, or resuscitation decisions were excluded. RESULTS: While a significant minority of frail older individuals would find them unwelcome, the majority would appreciate the chance to discuss end-of-life care, yet most do not have this opportunity. Attitudes to the timing of these discussions were variable, but most perceived the risk of leaving them too late. Most doctors believed it was their professional responsibility to initiate discussions, but felt limited by time pressures and the absence of a precipitating event. A wide range of barriers were identified including the reluctance of family members to discuss end-of-life care, the passive expectation that someone else would decide on an individual's behalf, and significant uncertainty concerning future illness and decline. CONCLUSION: The marked disparity between the majority of older individuals who would like the opportunity to discuss their end-of-life care and the minority that currently have this opportunity raises important questions if the wishes of this large group in society are to be respected. The challenge is to find effective ways of encouraging dialogue and choice within the constraints of the current healthcare systems and personal circumstances.

Eden Institute: Using Health Games for ASD Student and Staff Development.

Eden Autism Services is a leading-edge resource for children and adults suffering from more severe effects of autism spectrum disorder (ASD). The strategic use of games in the development of students, staff, teachers, parents, friends, and employers has advanced the quality of life of Eden's students and, consequently, their relationships, productivity, and happiness.