BackgroundFibromyalgia syndrome (FS) is characterized by the presence of widespread pain, fatigue, muscle weakness and reduced work capacity. Previous research has demonstrated that women with fibromyalgia have altered walking (gait) patterns, which may be a consequence of muscular pain. This altered gait is characterized by greater reliance on hip flexors rather than ankle plantar flexors and resembles gait patterns seen in normal individuals walking at higher speeds, suggesting that gait of individuals with fibromyalgia may be less efficient.This study compared rates of energy expenditure of 6 females with FS relative to 6 normal, age and weight matched controls, at various walking speeds on a motorized treadmill. Metabolic measurements including V02 (ml/kg/min), respirations, heart rate and calculated energy expenditures as well as the Borg Scale of Perceived Exertion scale ratings were determined at baseline and for 10 min while walking at each of 2, 4 and 5 km/hour on 1% grade. Kinematic recordings of limb and body movements while treadmill walking and separate measurements of ground reaction forces while walking over ground were also determined. In addition, all subjects completed the RAND 36-Item Health Survey (1.0).FindingsGait analysis results were similar to previous reports of altered gait patterns in FS females. Despite noticeable differences in gait patterns, no significant differences (p > 0.05) existed between the FS and control subjects on any metabolic measures at any walking speed. Total number of steps taken was also similar between groups. Ratings on the Borg Scale of Perceived Exertion, the RAND and self-reported levels of pain indicated significantly greater (p < 0.05) perceived effort and pain in FS subjects relative to control subjects during walking and daily activities.ConclusionsThe altered gait patterns and greater perceptions of effort and pain did not significantly increase the metabolic costs of walking in women with FS and hence, increased sensations of fatigue in FS women may not be related to alteration in metabolic cost of ambulation.
The synthetic cadaver is a high-fidelity model intended to replace or supplement other anatomy learning modalities. Academic attainment and student perceptions were examined in an undergraduate human anatomy course using a combination of plastic models and synthetic cadavers to learn lower body anatomy ("Experimental group"), compared to a Historical group who used only plastic models. Grades on an upper body test, for which both groups used only plastic models, were compared to ensure that no academic differences existed between groups (P = 0.7653). Students in the Experimental group performed better on the lower body test for which they used both plastic models and synthetic cadavers (median = 73.8% (95% CI: 72.0%-75.0%) compared to the Historical group (70.1% (95% CI: 68.3%-70.7%), P < 0.0001); however, less than half of students (49%) attributed this to the synthetic cadavers. Students' perception of laboratory resources (P < 0.0001) and learning experience (P < 0.0001) both improved with the addition of synthetic cadavers compared to using only plastic models, and 60% of students in the Experimental group agreed that the synthetic cadavers would be a key reason that they would choose that institution for undergraduate studies. This investigation showed improved student grades when plastic models and synthetic cadavers were combined, in addition to improved student perceptions of the learning experience. Results of the student questionnaires also suggested that although synthetic cadavers carry a notable up-front cost, they may be a useful recruitment tool for institutions. Anat Sci Educ 14: 605-614.
This study explored the use of an intriguing instrument which may provide a very similar, yet more sustainable, experience to human cadaver dissection in anatomy courses. The synthetic cadaver is structurally similar to a human cadaver but does not carry the same ethical and sustainability challenges. Students in an undergraduate human anatomy course completed two laboratory tests: Test 1 was completed prior to the introduction of two synthetic cadavers to the laboratory where the primary laboratory resources were plastic models. Test 2 was completed after the synthetic cadavers were introduced. Comparison of student lab test grades both pre and post synthetic cadaver introduction (“Experimental”) as well as to “Historical” cohorts of the course were used to assess student success. In addition, surveys comprised of 5‐point Likert items were used to assess student perceptions. Test 1 grades in the Experimental and Historical cohorts were compared to ensure that no academic differences existed between groups (p = 0.7653; z‐statistic = 0.2985). Students in the Experimental group performed better on Test 2 (median = 73.8% (95% CI: 72.0–75.0%) compared to the Historical group (70.1% (95% CI: 68.4%–70.1%), p < 0.0001). Students perceived laboratory resources to be necessary (95%), helpful (94%) and effective (87%), yet there was no change in these perceptions following the introduction of the synthetic cadavers. This investigation indicates that the synthetic cadavers were an effective learning tool in undergraduate human anatomy, and that student success was improved after using the synthetic cadavers, compared to when only plastic models were available. Support or Funding Information No funding was received for this work. Probability density estimates for laboratory test grades in the Historical (light blue) and Experimental (dark blue) cohorts. Grey areas represent the 95% confidence interval for the median grade. There was no difference in median Test 1 grades; however, the median Test 2 grade in the Experimental cohort was significantly higher than in the Historical cohort.
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