Comparative Analysis of the Diagonal Stride Technique during Roller Skiing and On-Snow Skiing in Youth Cross-Country Skiers

Roller skiing is one primary form of training method as it is an off-snow equivalent to cross-country (XC) skiing during the dry land preseason training, but the results could only be applied to on-snow skiing with appropriate caution. The aim of this present study was to investigate the similarities and differences in roller skiing and on-snow skiing with the diagonal stride (DS) technique. Six youth (age: 14.3 ± 2.9 years) skiers participated in this study. Two high-definition video camcorders and FastMove 3D Motion 2.23.3.3101 were used to obtain the three-dimensional kinematic data. The cycle characteristics and joint angle ROM of the DS technique while skiing on different surfaces were similar. Almost all joint angle-time curves that were obtained from roller skiing showed a moderate-to-high degree of similarity to the angle-time curves obtained from on-snow skiing, except the hip adduction-abduction angle. The differences between roller skiing and on-snow skiing were mainly found in the body and calf anteversion angles, and the joint angles at critical instants. DS roller skiing can simulate DS on-snow skiing to a large extent in youth athletes. The hip movement, knee flexion, and calf anteversion at ski/roller ski touchdown and take-off, pole inclination at pole touchdown, body anteversion angle, and trunk anteversion angle at pole touchdown were the points that required caution when transferring preseason practice roller skiing to on-snow skiing.

Modified Approach to Stroke Rehabilitation (MAStR): feasibility study of a method to apply procedural memory concepts to transfer training

OBJECTIVE

Training and implementation for a multidisciplinary stroke rehabilitation method emphasizing procedural memory.

BACKGROUND

Current practice in stroke rehabilitation relies on explicit memory, often compromised by stroke, failing to capitalize on better-preserved procedural memory skills. Recruitment of procedural memory requires consistency and practice, characteristics difficulty to promote on inpatient rehabilitation units. We designed a method Modified Approach to Stroke Rehabilitation (MAStR) to maximize consistency and practice for transfer training with stroke patients.

DESIGN

Phase I, single-group study. MAStR has two innovations: (1) simplification of instructions to only three words, other direction provided non-verbally; (2) having all rehabilitation staff apply the same approach for transfers. Staff training in MAStR included review of written material describing the rationale for MAStR and demonstration of a transfer using MAStR. Enrolled patients completed each transfer with MAStR in addition to standard rehabilitation therapy.

RESULTS

The MAStR method was taught to a large, multidisciplinary rehabilitation staff (n = 31). Training and certification required 15 min per staff member. Five stroke patients were enrolled. No transfers with MAStR resulted in injury, no negative feedback was received from staff or patients. Staff reported satisfaction with the brief MAStR training and reported transfers were easier to complete with the MAStR method.

CONCLUSIONS

Feasibility was demonstrated for an innovative application of procedural memory concepts to stroke rehabilitation. All rehabilitation disciplines were successfully trained. MAStR was well-tolerated and liked by rehabilitation staff and patients. These results support pursuit of a Phase II pilot study.

Blended Learning in Obstetrics and Gynecology Resident Education: Impact on Resident Clinical Performance

PROBLEM

Effects of residents' blended learning on their clinical performance have rarely been reported. A blended learning pilot program was instituted at Southern Illinois University School of Medicine's Obstetrics and Gynecology program. One of the modules was chronic hypertension in pregnancy. We sought to evaluate if the resident blended learning was transferred to their clinical performance six months after the module.

INTERVENTION

A review of patient charts demonstrated inadequate documentation of history, evaluation, and counseling of patients with chronic hypertension at the first prenatal visit by Obstetrics and Gynecology (OB/GYN) residents. A blended learning module on chronic hypertension in pregnancy was then provided to the residents. A retrospective chart review was then performed to assess behavioral changes in the OB/GYN residents.

CONTEXT

This intervention was carried out at the Department of Obstetrics and Gynecology, Southern Illinois University. All 16 OB/GYN residents were enrolled in this module as part of their educational curriculum. A query of all prenatal patients diagnosed with chronic hypertension presenting to the OB/GYN resident clinics four months prior to the implementation of the blended learning module (March 2015-June 2015) and six months after (July 20, 2015-February 2016) was performed. Data were collected from outpatient charts utilizing the electronic medical record. Data were abstracted from resident documentation at the first prenatal visit.

OUTCOME

The residents thought that the blended learning module was applicable to performance improvement in the real-world setting. Patients evaluated before (n = 10) and after (n = 7) the intervention were compared. After the intervention, there was an increase in assessment of baseline liver enzymes, referral for electrocardiogram, and early assessment for diabetes in the obese patients. More patients were provided a blood pressure cuff after the module (71.4% vs. 20%). Data were provided to the residents in an informal setting. Discussion during this session suggested that inconsistent use of the algorithm and incomplete documentation were reasons for the findings.

LESSONS LEARNED

This study suggests that blended learning may be a viable tool to support sustained changes in the performance of OB/GYN residents. Scheduled follow-up should be employed to facilitate and ensure continued learning and behavioral changes.