Objectives: Gait and mobility problems are difficult to treat in people with Parkinson's disease. The Rehabilitation in Parkinson's Disease: Strategies for Cueing (RESCUE) trial investigated the effects of a home physiotherapy programme based on rhythmical cueing on gait and gait-related activity. Methods: A single-blind randomised crossover trial was set up, including 153 patients with Parkinson's disease aged between 41 and 80 years and in Hoehn and Yahr stage II-IV. Subjects allocated to early intervention (n = 76) received a 3-week home cueing programme using a prototype cueing device, followed by 3 weeks without training. Patients allocated to late intervention (n = 77) underwent the same intervention and control period in reverse order. After the initial 6 weeks, both groups had a 6-week follow-up without training. Posture and gait scores (PG scores) measured at 3, 6 and 12 weeks by blinded testers were the primary outcome measure. Secondary outcomes included specific measures on gait, freezing and balance, functional activities, quality of life and carer strain. Results: Small but significant improvements were found after intervention of 4.2% on the PG scores (p = 0.005). Severity of freezing was reduced by 5.5% in freezers only (p = 0.007). Gait speed (p = 0.005), step length (p,0.001) and timed balance tests (p = 0.003) improved in the full cohort. Other than a greater confidence to carry out functional activities (Falls Efficacy Scale, p = 0.04), no carry-over effects were observed in functional and quality of life domains. Effects of intervention had reduced considerably at 6-week follow-up. Conclusions: Cueing training in the home has specific effects on gait, freezing and balance. The decline in effectiveness of intervention effects underscores the need for permanent cueing devices and follow-up treatment. Cueing training may be a useful therapeutic adjunct to the overall management of gait disturbance in Parkinson's disease.
Textile composites made of woven fabrics have demonstrated excellent mechanical properties for the production of high specific-strength products. Research efforts in the woven fabric sheet forming are currently at a point where benchmarking will lead to major advances in understanding both the strengths and the limitations of existing experimental and modeling approaches. Test results can provide valuable information for the material characterization and forming process design of woven composites if researchers know how to interpret the results obtained from varying test methods appropriately. An international group of academic and industry researchers has gathered to design and conduct benchmarking tests of interest to the composite sheet forming community. Shear deformation is the dominative deformation mode for woven fabrics in forming; therefore, trellis-frame (picture-frame) and biasextension tests for both balanced and unbalanced fabrics have been conducted and compared through this collaborative effort. Tests were conducted by seven international research institutions on three identical woven fabrics. Both the variations in the setup of each research laboratory and the normalization methods used to compare the test results are presented and discussed. With an understanding of the effects of testing variations on the results and the normalization methods, numerical modeling efforts can commence and new testing methods can be developed to advance the field.
Only one high-quality study, specifically focused on the effects of auditory rhythmical cueing, suggesting that the walking speed of patients with Parkinson's disease can be positively influenced. However, it is unclear whether positive effects identified in the laboratory can be generalized to improved activities of daily living (ADLs) and reduced frequency of falls in the community. In addition, the sustainability of a cueing training programme remains uncertain.
This study points to fact that physiotherapists might need to carefully adjust the cueing frequency to the needs of patients with and without freezing. On the basis of the present results we recommend to lower the frequency setting for freezers, whereas for non-freezers an increase of up to +10% may have potential therapeutic use.
Full-field strain measurements are applied in studies of textile deformability during composite processing: (1) in testing of shear and tensile deformations of textiles (picture frame, bias and biaxial extension test) as an ''optical extensometer'', allowing accurate assessment of the sample deformation, which may differ significantly from the deformation applied by the testing device; (2) to study mechanisms of the textile deformation on the scale of the textile unit cell and of the individual yarns (meso-and micro-scale full-field strain measurements); (3) to measure the 3D-deformed shape and the distribution of local deformations (e.g., shear angles) of a textile reinforcement after draping, providing input data for the validation of material drape models and for the prediction of the consolidated part performance via structural finite element analysis. This paper discusses these three applications of the full-field strain measurements, providing examples of studies of deformability of woven (glass, glass/PP) and non-crimp (carbon) textile reinforcements. The authors conclude that optical full-field strain techniques are the preferable (sometimes the only) way of assuring correct deformation measurements during tensile or shear tests of textile.
Results of picture frame shear tests with optical registration of the strain fields are presented for glass (plain and twill, three types) and glass/PP woven (plain and twill) fabric reinforcements for composite materials. Four problems were investigated. (1) How does the shear diagram vary with differences in test conditions? The major factor is the sample pretension, which is influenced by its gripping, removing/preserving yarns near the grips and “conditioning” in the shear cycles. (2) Does the shear of the fabric differ from the pure shear prescribed by the frame? The differences are normally negligible. (3) How large are the variations of the local fabric shear? The scatter of the local fabric shear does not exceed 2°. (4) How is shear of the fabric translated into deformations of the yarns on the micro-scale? Different stages of the fabric deformation are identified: rotation of the yarns followed by their lateral compression.
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