Understanding the Technology Acceptance and Usability of a New Device for Hand Therapy: Qualitative Descriptive Study.

BACKGROUND: Upper extremity function plays a critical role in completing activities of daily living, employment, and participating in recreational activities. The FEPSim device is a medical device for hand and wrist rehabilitation that can be adjusted according to the patient's requirements in rehabilitation. Furthermore, the FEPSim can be used to assess the patient's strength and range of motion of the forearm, wrist, and hand. At present, the acceptance and usability of the FEPSim have not been tested in a clinical setting, with limited perspectives from rehabilitation-providing clinicians. OBJECTIVE: This study aims to understand the factors related to the acceptance and usability of the FEPSim device. Upper limb disorders are prevalent across populations. The impact of upper limb disorders, both acute and chronic, puts a significant burden on the Canadian health care system. METHODS: A qualitative descriptive study was conducted that involved face-to-face semistructured interviews with hand therapists from hand therapy services who used the FEPSim device. We used purposive sampling to recruit 10 participants over a period of 14 months. Semistructured interview questions (topic-guided) examined the technology acceptance and usability of the FEPSim device. RESULTS: We found 6 factors to be critical aspects of the acceptance and usability of the FEPSim device. These factors were (1) useful for therapy, (2) effortlessness, (3) environmental conditions, (4) internal encouragement, (5) technological aesthetics, and (6) use. CONCLUSIONS: The FEPSim device was widely accepted by the therapists. The use of the FEPSim device is a feasible alternative for supporting hand therapy. TRIAL REGISTRATION: ISRCTN Registry ISRCTN13656014; https://www.isrctn.com/ISRCTN13656014.

Overnight fasting compromises exercise intensity and volume during sprint interval training but improves high-intensity aerobic endurance.

BACKGROUND: The combined effects of sprint interval training (SIT) and exercising in the fasted state are unknown. We compared the effects of SIT with exogenous carbohydrate supplementation (SIT-CHO) and SIT following overnight fast (SIT-Fast) on aerobic capacity (peak oxygen consumption: V̇O2peak) and high-intensity aerobic endurance (time-to-exhaustion at 85% V̇O2peak [T85%]). METHODS: Twenty male cyclists were randomized to SIT-CHO and SIT-Fast. Both groups performed 30-second all-out cycling followed by 4-minute active recovery 3 times per week for 4 weeks, with the number of sprint bouts progressing from 4 to 7. Peak power output (PPO) and total mechanical work were measured for each sprint interval bout. The SIT-CHO group performed exercise sessions following breakfast and consumed carbohydrate drink during exercise, whereas the SIT-Fast group performed exercise sessions following overnight fast and consumed water during exercise. Before and after training, V̇O2peak and T85% were assessed. Blood glucose, non-esterified fatty acids, insulin and glucagon concentrations were measured during T85%. RESULTS: Overall PPO and mechanical work were lower in SIT-Fast than SIT-CHO (3664.9 vs. 3871.7 J/kg; P=0.021 and 10.6 vs. 9.9 W/kg; P=0.010, respectively). Post-training V̇O2peak did not differ between groups. Baseline-adjusted post-training T85% was longer in SIT-Fast compared to SIT-CHO (19.7±3.0 vs. 16.6±3.0 minutes, ANCOVA P=0.038) despite no changes in circulating energy substrates or hormones. CONCLUSIONS: Our results suggest that SIT-Fast compromises exercise intensity and volume but still can have a greater impact on the ability to sustain high-intensity aerobic endurance exercise compared to SIT-CHO.

Effect of aerobic exercise intensity on glycemic control in type 2 diabetes: a meta-analysis of head-to-head randomized trials.

AIMS: To conduct a meta-analysis of head-to-head trials comparing aerobic exercise training of different intensities on glycemic control in type 2 diabetes. METHODS: Databases, including MEDLINE and EMBASE, were searched up to January 2016. Randomized trials of at least 12 weeks in duration that compared two exercise interventions of different intensities were identified. Two reviewers independently extracted data from eligible trials. Using fixed effect model, weighted mean differences (WMD) between different exercise intensities were calculated for changes in glycated hemoglobin (HbA1c) and secondary outcomes, such as fasting glucose and fasting insulin. RESULTS: Eight studies with a total of 235 participants were eligible. The exercise interventions lasted from 12 weeks to 6 months. The prescribed exercise intensities varied among studies. Four studies utilized vigorous exercise intensities for short durations by performing interval training. Overall, higher-intensity exercise resulted in a greater reduction in HbA1c compared to lower-intensity exercise (WMD = -0.22 %; 95 % confidence interval [-0.38, -0.06]; or -2.4 mmol/mol [-4.15, -0.66], I (2) = 0). Adherence to exercise and proportion of dropouts did not differ within trials. No adverse events were reported in these small trials with selected inclusion criteria. CONCLUSIONS: Although our meta-analysis had a limited sample size, increasing exercise intensity safely accentuated reductions in HbA1c in some people with type 2 diabetes. Different approaches have been used to increase exercise intensity (i.e., some used interval training, whereas others used higher-intensity continuous exercise). However, at this time, it is unclear which form, if any, leads to the most favorable results.