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The pilot study: Why we have learnt?
Abstracts / Journal of Science and Medicine in Sport 20S (2017) e32–e66
returning individuals back to early activity following certain bony or soft tissue pathologies or lower-limb surgical procedures. This information is also useful from a repetitive loading standpoint (to prevent overuse injury) or for exercise recommendations for those at greater risk for exacerbating chronic joint pathology. http://dx.doi.org/10.1016/j.jsams.2017.01.094 72 The pilot study: Why we have learnt? Y. Kaplan 1,∗ , E. Witwrouw 2 1 Physical Therapy and Sports Medicine Institute, Lerner Sports Center, Hebrew University, Israel 2 Department of Rehabilitation Sciences & Physiotherapy, Ghent University, Belgium
Introduction: Although pilot studies typically form the basis for further confirmatory studies, most do not evolve into subsequent published major trials. They are still poorly reported with inappropriate emphasis on their importance. Aims: To describe what our research team learnt from conducting a one-season pilot intervention study in order to reduce the incidence and severity of injuries in American flag football. Methods: A brief overview of the pilot study is presented, analyzing how the authors evaluated the package of interventions, detected the willingness of players to participate and comply with their intervention program, analyzed its financial costs and detected planning errors and faults in the equipment design. Results: The pilot study enabled the authors to make the necessary changes in preparation for their 2-season intervention study which resulted in significantly increased players’ compliance rates, improved equipment design, decreased costs, and a further reduction in the incidence and severity of sports injuries. Conclusion: The success of the authors’ pilot study highlights the importance of using such a study to assist in reducing costs, improve the quality of research, avoid planning errors, and most importantly to improve player compliance. Pilot trial design and analysis is an area of clinical research that warrants further study, as a means to ensure both effective use of limited resources and appropriate interpretation of results. http://dx.doi.org/10.1016/j.jsams.2017.01.095 73 Clinical implications of changing parameters on an elliptical trainer Y. Kaplan 1,∗ , E. Witwrouw 2 , M. Nyska 3 1
Physical Therapy and Sports Medicine Institute, Lerner Sports Center, Hebrew University, Israel 2 Department of Rehabilitation Sciences & Physiotherapy, Ghent University, Belgium 3 Department of Orthopedic Surgery, Meir Hospital, Israel Purpose: To investigate the referent average percentage body weight (APBW) values, weight-bearing distribution patterns (WBDP) and cadence values on the entire, hind, and forefoot during changing resistance and incline on an elliptical trainer, as well as to suggest clinical implications. Method: Twenty four asymptomatic subjects participated (mean age = 29.54 yrs, range 21–69, SD = 12.64). The SmartstepTM weight-bearing gait analysis system was utilized to measure the values. The protocol included three consecutive tests of changing resistance and incline within a speed range of 70–95 steps/min.
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Results: The entire foot APBW values ranged between 70% and 81%, the hind foot values, between 27% and 57% and the forefoot values, between 42% and 70%. Increasing the resistance had a significant increase on APBW values (p < 0.05), whilst increase the incline had little effect (p > 0.05). The feet remained in the stance phase consistently more percentage time compared to the swing phase (p < 0.05). Conclusions: Elliptical exercise can be started immediately if more than 30% body weight on the heel and 40% on the forefoot is permitted. These findings may assist the rehabilitation team when considering returning individuals back to weight-bearing activities following certain bony or soft tissue pathologies or lower-limb surgical procedures where full weight bearing may be limited. http://dx.doi.org/10.1016/j.jsams.2017.01.096 74 Does the use of pedal-less bicycles improve stability scores in six to ten years old children diagnosed with autism spectrum disorder? A. Shim 1,∗ , S. Peterson 2 , J. Turbes 3 , E. Kay 1 , D. Newman 4 1
Briar Cliff University, United States Pier Center of Autism, United States 3 NW AEA, United States 4 Florida Atlantic University, United States 2
Introduction: The purpose of this study was to determine if a bicycle without pedals could improve Center of pressure or Limit of Stability scores of 6–10 year old children diagnosed with Autism Spectrum Disorder within a five week time period. Currently, the investigators are not aware of any past studies or investigations that address this issue. Methods: A one group repeated measures design was selected for this five week study. A sample of eight healthy children, aged six to ten years old were recruited to a local Autism center in Sioux City, Iowa. Permissions were requested and received by the Autism center and the parents to perform this study. The investigators tested each subject on a Bertec Computerized Posturography Plate every week on the same day of each week for five consecutive weeks as well as performed an ADOS evaluation to determine each child’s level of Autism. The group used Strider bicycles on a modified race course for a 20–30 min duration, three times per week for five consecutive weeks. A repeated measures multiple analysis of variance was used to determine if Center of Pressure or Limit of Stability scores improved significantly within the group during the five week duration. Results: Significant differences in mean performance were detected within the group for Limit of Stability in the anterior plane (p-value = 0.001), in the left sagittal (0.021), the right sagittal plane (<0.001), and the posterior plane (0.004). Discussion: There was evidence of significant association between pedal-less bicycles and mean stability scores in six to ten year old children who were diagnosed with Autism Spectrum Disorder within five weeks of training, when observing Limit of Stability scores in all four planes. There were no differences observed with children who were determined to have lower or higher ADOS scores with regards to stability scores over the five weeks. These observations could possibly reduce or eliminate the use of training wheels as a progression towards pedal bicycles in young children diagnosed with Autism Spectrum Disorder. http://dx.doi.org/10.1016/j.jsams.2017.01.097
returning individuals back to early activity following certain bony or soft tissue pathologies or lower-limb surgical procedures. This information is also useful from a repetitive loading standpoint (to prevent overuse injury) or for exercise recommendations for those at greater risk for exacerbating chronic joint pathology. http://dx.doi.org/10.1016/j.jsams.2017.01.094 72 The pilot study: Why we have learnt? Y. Kaplan 1,∗ , E. Witwrouw 2 1 Physical Therapy and Sports Medicine Institute, Lerner Sports Center, Hebrew University, Israel 2 Department of Rehabilitation Sciences & Physiotherapy, Ghent University, Belgium
Introduction: Although pilot studies typically form the basis for further confirmatory studies, most do not evolve into subsequent published major trials. They are still poorly reported with inappropriate emphasis on their importance. Aims: To describe what our research team learnt from conducting a one-season pilot intervention study in order to reduce the incidence and severity of injuries in American flag football. Methods: A brief overview of the pilot study is presented, analyzing how the authors evaluated the package of interventions, detected the willingness of players to participate and comply with their intervention program, analyzed its financial costs and detected planning errors and faults in the equipment design. Results: The pilot study enabled the authors to make the necessary changes in preparation for their 2-season intervention study which resulted in significantly increased players’ compliance rates, improved equipment design, decreased costs, and a further reduction in the incidence and severity of sports injuries. Conclusion: The success of the authors’ pilot study highlights the importance of using such a study to assist in reducing costs, improve the quality of research, avoid planning errors, and most importantly to improve player compliance. Pilot trial design and analysis is an area of clinical research that warrants further study, as a means to ensure both effective use of limited resources and appropriate interpretation of results. http://dx.doi.org/10.1016/j.jsams.2017.01.095 73 Clinical implications of changing parameters on an elliptical trainer Y. Kaplan 1,∗ , E. Witwrouw 2 , M. Nyska 3 1
Physical Therapy and Sports Medicine Institute, Lerner Sports Center, Hebrew University, Israel 2 Department of Rehabilitation Sciences & Physiotherapy, Ghent University, Belgium 3 Department of Orthopedic Surgery, Meir Hospital, Israel Purpose: To investigate the referent average percentage body weight (APBW) values, weight-bearing distribution patterns (WBDP) and cadence values on the entire, hind, and forefoot during changing resistance and incline on an elliptical trainer, as well as to suggest clinical implications. Method: Twenty four asymptomatic subjects participated (mean age = 29.54 yrs, range 21–69, SD = 12.64). The SmartstepTM weight-bearing gait analysis system was utilized to measure the values. The protocol included three consecutive tests of changing resistance and incline within a speed range of 70–95 steps/min.
e33
Results: The entire foot APBW values ranged between 70% and 81%, the hind foot values, between 27% and 57% and the forefoot values, between 42% and 70%. Increasing the resistance had a significant increase on APBW values (p < 0.05), whilst increase the incline had little effect (p > 0.05). The feet remained in the stance phase consistently more percentage time compared to the swing phase (p < 0.05). Conclusions: Elliptical exercise can be started immediately if more than 30% body weight on the heel and 40% on the forefoot is permitted. These findings may assist the rehabilitation team when considering returning individuals back to weight-bearing activities following certain bony or soft tissue pathologies or lower-limb surgical procedures where full weight bearing may be limited. http://dx.doi.org/10.1016/j.jsams.2017.01.096 74 Does the use of pedal-less bicycles improve stability scores in six to ten years old children diagnosed with autism spectrum disorder? A. Shim 1,∗ , S. Peterson 2 , J. Turbes 3 , E. Kay 1 , D. Newman 4 1
Briar Cliff University, United States Pier Center of Autism, United States 3 NW AEA, United States 4 Florida Atlantic University, United States 2
Introduction: The purpose of this study was to determine if a bicycle without pedals could improve Center of pressure or Limit of Stability scores of 6–10 year old children diagnosed with Autism Spectrum Disorder within a five week time period. Currently, the investigators are not aware of any past studies or investigations that address this issue. Methods: A one group repeated measures design was selected for this five week study. A sample of eight healthy children, aged six to ten years old were recruited to a local Autism center in Sioux City, Iowa. Permissions were requested and received by the Autism center and the parents to perform this study. The investigators tested each subject on a Bertec Computerized Posturography Plate every week on the same day of each week for five consecutive weeks as well as performed an ADOS evaluation to determine each child’s level of Autism. The group used Strider bicycles on a modified race course for a 20–30 min duration, three times per week for five consecutive weeks. A repeated measures multiple analysis of variance was used to determine if Center of Pressure or Limit of Stability scores improved significantly within the group during the five week duration. Results: Significant differences in mean performance were detected within the group for Limit of Stability in the anterior plane (p-value = 0.001), in the left sagittal (0.021), the right sagittal plane (<0.001), and the posterior plane (0.004). Discussion: There was evidence of significant association between pedal-less bicycles and mean stability scores in six to ten year old children who were diagnosed with Autism Spectrum Disorder within five weeks of training, when observing Limit of Stability scores in all four planes. There were no differences observed with children who were determined to have lower or higher ADOS scores with regards to stability scores over the five weeks. These observations could possibly reduce or eliminate the use of training wheels as a progression towards pedal bicycles in young children diagnosed with Autism Spectrum Disorder. http://dx.doi.org/10.1016/j.jsams.2017.01.097