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Designing innovative high quality educational programmes to meet the workforce needs in emerging interdisciplinary areas of practice can present challenges to academics, students, employers and industrial partners. This paper demonstrates how the Tuning Process successfully helped to construct benchmark learning outcomes and competences in the area of healthcare practice where advanced technologies are used to improve movement namely Rehabilitation Technologies (RTs). The paper also discusses the engagement of patients, carers and carer organisations within the development of competences. Due to changing demographics, limited resources and the availability of technology, rehabilitation technologies are starting to be used for the assessment and treatment of patients. However there are currently no European transnational Bachelor or Master programmes targeted at educating people for the design, development, use and evaluation of these technologies. The contemporary field is predominantly staffed and resourced by engineering scientists and clinicians who were primarily educated in their primary discipline. The first generations of rehabilitation technologists have established this specialist field through invention, perseverance, and collaborative working. However, there is now a recognition that new and complementary skill sets are required by future graduates, whether engineering scientists or clinicians, so as to better meet the needs of clients and the employment market whether in the domains of industry, research, academia or clinical practice. This project demonstrates how a group of European specialist rehabilitation technologists, supported by educationalists, collaborated to identify and develop the core competences and learning outcomes required by future Master's (second cycle) graduates in this new discipline. Building on the work of the Tuning Process and applying the principles embedded in the Bologna Process, future employability needs are determined through an imaginative, technological and cost conscious entrepreneurial approach to education.

To investigate the validity and reliability of using the Valedo® system to measure trunk Range of Motion (ROM) during performance of the streamlined Wolf Motor Function Test (SWMFT). Twenty chronic strokes and 20 age-matched healthy participants performed SWMFT while wearing Valedo® sensors on their trunks to capture trunk movements. A paired sample T-test was used to examine the validity of the system in distinguishing between the healthy and stroke group, and between the affected and unaffected sides in the stroke group. Interclass correlation coefficients were used to assess the inter-rater and intra-rater reliability (between-days) with 95% CI. The Valedo® system was able to distinguish between stroke and healthy participants; stroke participants employed greater trunk range of movements than the healthy controls in all tasks (p <.01). Furthermore, the Valedo® system enabled differentiation between affected and unaffected hands of people within the stroke group. The reliability for the stroke group was good to excellent with intrarater reliability (ICC = 0.71–0.92) and interrater reliability (ICC = 0.63–0.95). The Valedo system demonstrates an acceptable level of validity and reliability for measuring trunk ROM during the Streamlined Wolf Motor Function Test (SWMFT). Future studies with a larger sample size, different levels of upper limb impairment are warranted. [ABSTRACT FROM AUTHOR]

A model of the upper extremity is developed in which the forearm is constrained to lie in a horizontal plane and electrical stimulation is applied to the triceps muscle. Identification procedures are described to estimate the unknown parameters using tests that can be performed in a short period of time. Examples of identified parameters obtained experimentally are presented for both stroke patients and unimpaired subjects. A discussion concerning the identification's repeatability, together with results confirming the accuracy of the overall representation, is given. The model has been used during clinical trials in which electrical stimulation is applied to the triceps muscle of a number of stroke patients for the purpose of improving both their performance at reaching tasks and their level of voluntary control over their impaired arm. Its purpose in this context is threefold: Firstly, changes occurring in the levels of stiffness and spasticity in each subject's arm can be monitored by comparing frictional components of models identified at different times during treatment. Secondly, the model is used to calculate the moments applied during tracking tasks that are due to a patient's voluntary effort, and it therefore constitutes a useful tool with which to analyze their performance. Thirdly, the model is used to derive the advanced controllers that govern the level of stimulation applied to subjects over the course of the treatment. Details are provided to show how the model is applied in each case, and sample results are shown. [DOI: 10.1115/1.3005332]

Trunk control is thought to contribute to upper extremity function. It is unclear whether recovery of trunk control has an impact on the recovery of the upper extremity in people with stroke. This longitudinal study monitored the recovery of trunk control and upper extremity in the first 6 months following stroke. Forty-five participants with stroke were assessed monthly for 6 months following stroke. Trunk control was assessed using the Trunk Impairment Scale (TIS); upper extremity impairment and function were assessed with the Fugl-Meyer (FMA) and Streamlined Wolf Motor Function Test (SWMFT) respectively. The SWMFT included the performance time (SWMFT-Time) and functional ability scale (SWMFT-FAS). The individual growth curve modeling was used to analyze the longitudinal data. The recovery curve of TIS, FMA, SWMFT-Time and SWMFT-FAS followed a quadratic trend, with the rate of recovery decreasing from the first to sixth month. As TIS score improved over time, FMA, SWMFT-Time and SWMFT-FAS improved in parallel with the TIS score. TIS at each time point was found to be a significant predictor of FMA, SWMFT-Time and SWMFT-FAS at 6 months post stroke. Our work has provided, for the first time, substantial evidence that the pattern of recovery of trunk control is similar to that of the recovery of upper extremity following stroke. In addition, this study provides evidence on which to design a prospective study to evaluate whether improvement in trunk control early post-stroke results in better long-term upper extremity function. [ABSTRACT FROM AUTHOR]

The Arthritis Self-Efficacy Scale-8 (ASES-8) is one of the most commonly used scales to measure patient-reported arthritis-specific self-efficacy. However, evidence about the validity and reliability of ASES-8 in an Arabic-speaking arthritis population is lacking. This study aimed to cross-culturally adapt and assess aspects of validity and reliability of the Arabic version of the ASES-8. The ASES-8 was translated into the Arabic language using the back-translation method, and administered to 67 patients with rheumatoid arthritis (RA). Construct validation methods used exploratory factor analysis and correlating the ASES-8 scores with disease-related variables expected to be related to the arthritis self-efficacy construct. An internal consistency test was conducted. Floor and ceiling effects were considered present if more than 15% of patients achieved high (=10) and low (=1) scores on the Arabic ASES-8 for both the scale and item scores. Exploratory factor analysis demonstrated a one-factor solution (factor loadings: 0.54–0.81). ASES-8 scores were correlated with all measures assessed (r = −0.24 to −0.57 and r = 0.06–0.66), demonstrating construct validity. Internal consistency was acceptable for measures of Cronbach's alpha (0.86–0.88). The scale did not exhibit ceiling or floor effects. The Arabic version of ASES-8 is valid and reliable for evaluating self-efficacy in patients with rheumatoid arthritis. The Arthritis Self-Efficacy Scale (ASES-8) questionnaire was translated and adapted for use in Arabic language. This questionnaire is a valid and reliable instrument for evaluating self-efficacy among Arabic individuals with rheumatoid arthritis. This will support greater use of this tool worldwide in clinical and research practices that include Arabic people. [ABSTRACT FROM AUTHOR]

The Trunk Impairment Scale (TIS) is recommended for use in clinical research to assess trunk impairment post-stroke. However, it is observer dependent and does not consider the quality of trunk movement. To address these challenges, this study proposes an instrumented TIS (iTIS). This study aims to investigate the intra-rater and inter-rater reliability of the iTIS in chronic stroke patients. Trunk impairment was assessed in 20 patients with stroke using the iTIS Valedo system; three sensors were fixed to the skin on the sternum, L1 and S1 levels. Interclass correlation coefficients were used to assess the inter-rater and intra-rater reliability (between days) with 95% CI. Reliability for the dynamic subscale parameters was good to excellent (intra-rater ICC = 0.60–0.95; inter-rater ICC = 0.59–0.93); however, reliability for the coordination parameters was poor to good (intra-rater ICC = 0.05–0.72) and poor to excellent (inter-rater ICC = 0.04–0.78). The iTIS demonstrates an acceptable level of reliability for dynamic subscale measurement in research and clinical practice. Further studies could use larger sample sizes and improve the iTIS methodology by employing additional sensors on the limbs to detect compensatory movements. [ABSTRACT FROM AUTHOR]