RESUMEN
Knee osteoarthritis is among the most prevalent chronic diseases. Total knee arthroplasty is a common solution that effectively addresses the continued structural degeneration of the articular cartilage. However, effective physical therapy is critical for recovery. Despite participating in physical therapy, many patients fail to recover. This study investigated the potential efficacy of a behaviorally informed approach to surface electromyographic biofeedback following total knee arthroplasty relative to the clinical standard, neuromuscular electrical stimulation. The surface electromyographic biofeedback procedure incorporated improved techniques for establishing a baseline and individualized and adjusting criteria for feedback. The findings suggest some advantages for surface electromyographic biofeedback over neuromuscular electrical stimulation in quadriceps strength, range of motion, functional recovery, and quality of life. Behaviorally informed surface electromyographic biofeedback holds promise for total knee arthroplasty recovery and these data suggest considerable room for collaboration between behavior analysts and physical therapists.
Asunto(s)
Artroplastia de Reemplazo de Rodilla , Biorretroalimentación Psicológica , Electromiografía , Humanos , Artroplastia de Reemplazo de Rodilla/rehabilitación , Biorretroalimentación Psicológica/métodos , Electromiografía/métodos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Recuperación de la Función/fisiología , Rango del Movimiento Articular/fisiología , Calidad de Vida , Osteoartritis de la Rodilla/cirugíaRESUMEN
One of the key challenges facing instructors of undergraduate introduction to behavior analysis courses is helping students learn to identify the environmental variables that control behavior. Goldiamond frequently employed exploratory and targeted logs to help his clients understand the environmental controlling variables that supported their behavior. We describe a preliminary analysis of the use of adaptations of Goldiamond's exploratory logs in the context of a behavior change project incorporated in several undergraduate introductory behavior analysis courses across three semesters. Three "levels" of exploratory logs were created in which students were asked to record an increasing number of the components of the three-term contingency. Students were also asked to answer the question, "why did this behavior occur" for each behavior reported. In the first semester, students received feedback on their exploratory logs through an online course management system and in the subsequent two semesters students received feedback on their exploratory logs during class periods. Each level of the students' exploratory logs was scored according to the type of explanation (e.g., explanatory fiction, behavioral) students provided for the behavior. The results show that the combination of the behavior change project and in-class feedback promoted more behavioral explanations for the behaviors recorded than the combination of the behavior change project and feedback provided through the online, course management system.
RESUMEN
[This corrects the article DOI: 10.1007/s40617-021-00608-1.].
RESUMEN
Many problems that fall in medical domains of inquiry have behavioral components that can be optimized to increase benefits for patients. For example, although surgical intervention is effective in reducing the pain resulting from osteoarthritis of the knee, patients often struggle to regain complete functional use of the joint. In this translational study, we point to some ways in which behavioral contingencies of reinforcement are compromised, making the recovery process more difficult. We also report on the use of surface electromyography (sEMG) with healthy participants to create supplementary contingencies of reinforcement to support the development and maintenance of clinically relevant exercises. The procedures reported provide a proof-of-concept and can contribute to an increase in the systematic use of games and feedback in physical rehabilitation in recovery from knee surgery. The results of this translational study suggest an expanded role for applied behavior analysis in the domains of health and medicine.