RA patients are prone to ulnar deviation and swan-neck deformity even early after onset of the disease. Limitation of finger joint range of motion due to hand-finger deformation brings restriction to ADL in the workplace as well as in the home. Patients and caretakers of patients are often burdened by these limitations; however, RA hand-finger deformation experience equipment have not been developed to experience these limitations. We have developed a novel RA hand-finger deformation experience equipment with opened fingertips (RSE; RA hand/finger simulation equipment).
Objectives
To assess the utilisation of RSE in healthy volunteers (HV) to experience RA hand-finger dysfunction using DASH (Disabilities of the Arm, Shoulder and Hand), STEF (Simple Test for Evaluating Hand Function), and Purdue Pegboard.
Methods
We developed the following equipment: Type U to imitate extension limitation of metacarpophalangeal (MCP) joints seen in ulnar deviation; Type B which imitates flexion deformity of the distal interphalangeal (DIP) joints by seen in boutonniere deformity; and Type S which imitates flexion limitation of proximal interphalangeal (PIP) and interphalangeal (IP) joints by reversing the upper and lower ends of the Oval-8 Finger Splint (Fukui Co. Ltd, Japan). Types U and S were fitted on HV (index to pinky). RSE was evaluated using DASH, STEF and Purdue Pegboard in hand-finger function evaluation. Twenty-four RA patients with hand-finger deformation and Forty-one HV were included in this study to evaluate the equipment.
Results
Mean ±SD ages for RA patients was 67.4±8.0 years (95.8% female) and 38.2±17.7 for HV (63.4% female), respectively. Total hand-finger deformities for RA patients were 23 hands for ulnar deviation, 66 fingers for swan-neck deformity, and 33 fingers for boutonniere deformity. Randomization for RA patients was as follows: 13 DASH, 5 (10 hands) STEF, and 6 Purdue Pegboard. 10 HV were assigned to DASH, 10 to Purdue Pegboard, and 14 (28 hands) to STEF. HV were evaluated with RSE and without RSE. For DASH, STEF, and Purdue Pegboard, RA patients showed significant functional loss compared to HV. Significant function loss in RA patients was also observed with the RSE. However, no differences were seen between the RA group and the HV with RSE group (figure 1).
Conclusions
We developed the RSE, which allows for one to experience the decrease in function with RA hand-finger deformity. Our study showed that RSE use can indeed allow this experience. By using RSE, health care workers, patient caretakers and early RA patients can experience joint limitation of RA for educational purposes, personalised rehab programs, and development of self-help tools.
[Purpose] The purpose of this study was to clarify the relationship between physical therapy clinical educators' motivations and negative personal factors. [Participants and Methods] The authors sent a questionnaire on clinical education to 790 physical therapists working in hospitals across Japan, and received 345 valid responses. The study defined motivated and unmotivated clinical educators based on their answers to the "interests" and "enjoyment" aspects of clinical education. It also calculated the negative response rate out of 10 questions and odds ratio based on motivated clinical educators. [Results] The motivated group comprised 287 clinical educators (years of clinical experience: 8.1 ± 6.3) and the unmotivated group 58 (years of clinical experience: 7.0 ± 5.2). There was no statistically significant difference in years of clinical experience between the two groups. Two questions-"Is student guidance necessary for growth as a therapist (self-improvement)?" and "Do you want to learn about instructional methods?"-showed very high odds ratios. [Conclusion] This study reveals negative personal factors for the clinical educators who lack the will to educate students, such as preparation for clinical education, self-improvement, and cooperation with class instructors. Longitudinal research on motivated and unmotivated clinical educators will help identify these negative factors to improve their motivation.
Acoustic emission (AE) technique has been applied as an adaptive biomarker for evaluating the disorder of knee joint. Integrity analysis of knee joint involves a detail study of several anatomical parts of knee joint like bones, cartilage, tendons etc. Any damage of these anatomical parts causes several knee diseases like osteoarthritis (OA). The incidence of knee OA, a widely manifested knee disease, particularly in aging society, increases due to some damages in the cartilage of knee joint. The major concern of this disease (OA) is its incurability at its matured stage. However, early detection for adopting appropriate measures can reduce the risk of this disease [1], [2]. The present investigation focuses on the dynamical behavioral characterization of knee joint for its integrity analysis with acoustic emission (AE) characterizing parametric features. AE signals have been collected from different positions of tibia, patella, femur etc. by AE sensors with adaptive frequency bands for getting sufficient information about the condition of cartilage in knee joint. Data has been collected from the participants with different age groups without any knee problems as well as participants with knee diseases. All data have been clarified effectively to identify the proposed technique as an adaptive biomarker for monitoring knee condition in early stage of OA effectively.
