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BackgroundKnee extensor muscle performance is reduced after lower extremity trauma and orthopedic surgical interventions. At-home use of neuromuscular electrical stimulation (NMES) may improve functional recovery, but adherence to at-home interventions is low. Greater benefits from NMES may be realized with closer monitoring of adherence to at-home prescriptions and more frequent patient-provider interactions. ObjectiveThis study aimed to develop a cyber-physical system to monitor at-home adherence to NMES prescription and facilitate patient-provider communications to improve adherence in near real time. MethodsThe RehabTracker cyber-physical system was developed to accomplish this goal and comprises four components: (1) hardware modifications to a commercially available NMES therapy device to monitor device use and provide Bluetooth functionality; (2) an iPhone Operating System–based mobile health (mHealth) app that enables patient-provider communications in near real time; (3) a clinician portal to allow oversight of patient adherence with device use; and (4) a back-end server to store data, enable adherence analysis, and send automated push notifications to the patient. These four elements were designed to be fully compliant with the Health Insurance Portability and Accountability Act. The system underwent formative testing in a cohort of patients following anterior cruciate ligament rupture (n=7) to begin to assess face validity. ResultsCompared with the NMES device software–tracked device use, the RehabTracker system recorded 83% (40/48) of the rehabilitation sessions, with 100% (32/32) of all sessions logged by the system in 4 out of 7 patients. In patients for whom tracking of automated push notifications was enabled, 100% (29/29) of the push notifications sent by the back-end server were received by the patient. Process, hardware, and software issues contributing to these inaccuracies are detailed. ConclusionsRehabTracker represents a promising mHealth app for tracking and improving adherence with at-home NMES rehabilitation programs and warrants further refinement and testing.

Loss of quadriceps strength after total knee arthroplasty (TKA) is most pronounced acutely but persists long-term, negatively impacting physical function in daily activities. Neuromuscular electrical stimulation (NMES) early after surgery is an effective adjuvant to standard of care rehabilitation (SOC) for attenuating strength loss following TKA, but the mechanisms whereby NMES maintains strength are unclear. This work aimed to determine the effects of early NMES on quadriceps strength and skeletal muscle fiber size 2 weeks after TKA compared to SOC. Patients scheduled for primary, unilateral TKA were enrolled and randomized into SOC (n = 9) or NMES plus SOC (n = 10) groups. NMES was started within 48 h of TKA, with 45-min sessions twice a day for 2 weeks. Isometric quadriceps strength was assessed preoperatively and 2 weeks following TKA. Vastus lateralis muscle biopsies of the involved leg were performed at the same time points and immunohistochemistry conducted to assess muscle fiber cross-sectional area and distinguish fiber types. Groups did not differ in age, body mass index, sex distribution, or preoperative strength. Both groups got weaker postoperatively, but the NMES group had higher normalized strength. After 2 weeks, the group receiving NMES and SOC had significantly greater MHC IIA and MHC IIA/IIX fiber size compared to SOC alone, with no group differences in MHC I fiber size. These results suggest that NMES mitigates early muscle weakness following TKA, in part, via effects on fast-twitch, type II muscle fiber size. This investigation advances our understanding of how adjuvant, early postoperative NMES aids muscle strength recovery.

The purpose of the study is to close the gap in the literature regarding the Marzano Teacher Evaluation Model (MTEM) that lacks large scale empirical investigations to assess the predictability of the model. The study thoroughly reviews the extant literature from all teacher evaluation frameworks, particularly focusing on the large body of published studies that have investigated the correlations between teacher observation ratings and teacher value-added measures, then outlines the literature specific to the MTEM. The study extracted observation ratings from a collection platform and linked it to the Florida Department of Education teacher value-added measure, which controls for prior testing history and student-level characteristics. The study sample included over 12,000 teachers and validated the use of the MTEM, particularly in Florida, by upholding the magnitude of correlations found in other instructional frameworks and demonstrating that observation ratings were the largest predictor in multilevel models accounting for student, teacher and school level characteristics.

A pedagogical model called student-led academic teaming takes a different approach to personalizing instruction and meeting the multifaceted needs of each student without increasing teacher fatigue and burnout. With student-led academic teaming, students take increased ownership and accountability for their own and their peers' learning, relieving some of the pressure from the teacher and resulting in greater achievement gains. Student-led academic teaming is a major component of Schools for Rigor, a school transformation approach created by Learning Sciences International that also includes assessment of school systems through scientific protocols, professional learning and coaching for teachers and school leaders, and constant tracking of student evidence to drive improvement in teaching and learning. Schools for Rigor engages all leaders and staff in a common vision and language for rigorous instruction through academic teaming, which brings student ownership to the forefront of teaching and learning through shifts in lesson planning, classroom routines, instructional strategies, and expectations for teachers and students. This article discusses student-led academic teaming, how to empower English learning using this approach, and professional learning supports provided by Schools of Rigor. It closes with the findings from a study conducted by the Learning Sciences International Applied Research Center on Schools for Rigor, which builds capacity for student-led academic teaming through professional learning, assessment, and tracking for leaders and staff in the Des Moines Public Schools district.

Instructional leaders require timely and predictive data to guide post-pandemic systemic changes. We investigated the predictability of an observational instrument, the Rigor Appraisal, and its association with achievement and other school effectiveness measures in a sample of 53 schools in Illinois. We found that increases in the Rigor Appraisal had a small to moderate and statistically significant association with achievement, a positive and moderate statistically significant association with attendance, a negative relationship between referrals and suspensions, and a positive and moderate statistically significant association with the 5Essentials. Additionally, the implementation of academic teaming was associated with greater achievement in schools with more low-income students. We also found that leaders who conducted non-evaluative instructional walks experienced a positive and statistically significant impact on achievement. As such, the Rigor Appraisal merits further study in different contexts, as it shows promise as a leading indicator that can be used for the continuous improvement of instructional systems. [ABSTRACT FROM AUTHOR]

Background: Previous studies identified physical function limitations in older cancer survivors, but few have included objective measures and most focused on breast and prostate cancer survivors. The current study compared patient‐reported and objective physical function measures between older adults with and without a cancer history. Methods: Our cross‐sectional study used a nationally representative sample of community‐dwelling, Medicare beneficiaries from the 2015 National Health and Aging Trends Study (n = 7495). Data collected included patient‐reported physical function, including a composite physical capacity score and limitations in strength, mobility, and balance, and objectively measured physical performance metrics, including gait speed, five time sit‐to‐stand, tandem stand, and grip strength. All analyses were weighted to account for the complex sampling design. Results: Thirteen percent of participants (n = 829) reported a history of cancer, of which more than half (51%) reported a diagnosis other than breast or prostate cancer. In models adjusted for demographics and health history, older cancer survivors had lower Short Physical Performance Battery scores (unstandardized beta [B] = −0.36; 95% CI: −0.64, −0.08), slower gait speed (B = −0.03; 95% CI: −0.05, −0.01), reduced grip strength (B = −0.86; 95% CI: −1.44, −0.27), worse patient‐reported composite physical capacity (B = −0.43; 95% CI: −0.67, −0.18) and patient‐reported upper extremity strength (B = 1.27; 95% CI: 1.07, 1.50) compared to older adults without cancer. Additionally, the burden of physical function limitations was greater in women than in men, which may be explained by cancer type. Conclusions: Our results extend studies in breast and prostate cancer to show worse objective and patient‐reported physical function outcomes in older adults with a range of cancer types compared to those without a cancer history. Moreover, these burdens seem to disproportionately affect older adult women, underscoring the need for interventions to address functional limitations and prevent further health consequences of cancer and its treatment. [ABSTRACT FROM AUTHOR]