Purpose: To evaluate lower extremity mechanics and muscle activation associated with the sit-to-stand transfer using a portable lifting-seat device and to compare these data to an unassisted transfer in healthy young and older adults. Methods: Bilateral lower extremity and low back musculature electromyography, three-dimensional leg and trunk motion, and ground reaction forces were recorded from 10 young (mean age = 25) and 10 older (mean age = 69) adults during five trials of (i) no assist and (ii) assisted transfers. Data were time normalized to represent the period of seat-off to standing. Peak sagittal plane joint angles, moments, and muscle activity profiles were calculated. Analysis of variance models was used to test for main effects and interactions (α = 0.05). Results: Trunk, hip, and knee angles were significantly reduced and dorsiflexion increased with assisted transfer (p < 0.05). Peak hip and ankle joint moments were reduced (p < 0.05) and no change found in knee moments (p > 0.05). Peak muscle activity was lower during the assisted transfer (p < 0.05). Seat device effects were similar between age groups. Older adults used higher relative muscle activation. Conclusion: Variables indicative of sit-to-stand functional demand were reduced with lifting-seat device use. Data provide a framework for future recommendations on product prescription, use, and research pertaining to the advancement of adaptive seating. Implications for Rehabilitation Hip and trunk mechanical demands, and muscle activation were reduced with portable lifting seat device use. Greater ankle dorsiflexion was found with portable lifting seat device use, suggesting this range of motion should be considered when prescribing this device. Healthy older and younger adults used similar knee and trunk joint mechanics yet older adults completed the sit-to-stand trials with greater lower extremity and low back muscle activation.
Objective To determine how many Level 1 and Level 2 trauma centres in Canada have implemented a resuscitative endovascular balloon occlusion of the aorta (REBOA) program, and to identify facilitators and barriers to successful implementation of REBOA programs. Methods An electronic survey was developed and administered in November 2019 (updated in July 2021) via email to directors at all 32 Level 1 and Level 2 trauma centres across Canada, and to the medical director in PEI (no Level 1 or Level 2 capacity). Survey responses were supplemented by an online search in PubMed and the grey literature. Responses were analyzed using simple descriptive statistics including frequencies and proportions. Results We received responses from directors at 22 sites (17 Level 1 trauma centres, 4 Level 2 trauma centres, PEI) for a response rate of 66.7%. There are 6 Level 1 trauma centres with REBOA programs; all were implemented between 2017 and 2019. One additional Level 1 trauma centre that did not respond was found to have a REBOA program; thus, 21.9% (7/32) of Canadian Level 1 and Level 2 trauma centres have an existing REBOA program. These programs are located in three provinces (British Columbia, Ontario, Quebec). Five other centres are planning on implementing a REBOA program in the next 2 years. The number of REBOA cases performed ranged from 0 to 30 (median 2). Factors contributing most to successful program implementation were having physician champions and patient populations with sufficient REBOA candidates, while cost and lack of expertise were the greatest barriers identified. Conclusion As of July 2021, 21.9% (7/32) of Canadian Level 1 and Level 2 trauma centres have a REBOA program. Physician champions and a patient population with sufficient numbers of REBOA candidates were the most important factors contributing to successful implementation of these programs.
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