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Background Rapid onset of muscular fatigue is still one of the main issues of functional electrical stimulation (FES). A promising technique, known as distributed stimulation, aims to activate sub-units of a muscle at a lower stimulation frequency to increase fatigue-resistance. Besides a general agreement on the beneficial effects, the great heterogeneity of evaluation techniques, raises the demand for a standardized method to better reflect the requirements of a practical application. Methods This study investigated the fatigue-development of 6 paralysed quadriceps muscles over the course of 180 dynamic contractions, evaluating different electrode-configurations (conventional and distributed stimulation). For a standardized comparison, fatigue-testing was performed at 40% of the peak-torque during a maximal evoked contraction (MEC). Further, we assessed the isometric torque for each electrode-configuration at different knee-extension-angles (70°–170°, 10° steps). Results Our results showed no significant difference in the fatigue-index for any of the tested electrode-configurations, compared to conventional-stimulation. We conjecture that the positive effects of distributed stimulation become less pronounced at higher stimulation amplitudes. The isometric torque produced at different knee-extension angles was similar for most electrode-configurations. Maximal torque-production was found at 130°–140° knee-extension-angle, which correlates with the maximal knee-flexion-angles during running. Conclusion In most practical applications, FES is intended to initiate dynamic movements. Therefore, it is crucial to assess fatigue-resistance by using dynamic contractions. Reporting the relationship between produced torque and knee-extension-angle can help to observe the stability of a chosen electrode-configuration for a targeted range-of-motion. Additionally, we suggest to perform fatigue testing at higher forces (e.g. 40% of the maximal evoked torque) in pre-trained subjects with SCI to better reflect the practical demands of FES-applications.

Functional electrical stimulation (FES) is a technique used in rehabilitation, allowing the recreation or facilitation of a movement or function, by electrically inducing the activation of targeted muscles. FES during cycling often uses activation patterns which are based on the crank angle of the pedals. Dynamic changes in their underlying predefined geometrical models (e.g., change in seating position) can lead to desynchronised contractions. Adaptive algorithms with a real-time interpretation of anatomical segments can avoid this and open new possibilities for the automatic design of stimulation patterns. However, their ability to accurately and precisely detect stimulation triggering events has to be evaluated in order to ensure their adaptability to real-case applications in various conditions. In this study, three algorithms (Hilbert, BSgonio, and Gait Cycle Index (GCI) Observer) were evaluated on passive cycling inertial data of six participants with spinal cord injury (SCI). For standardised comparison, a linear phase reference baseline was used to define target events (i.e., 10%, 40%, 60%, and 90% of the cycle’s progress). Limits of agreement (LoA) of ±10% of the cycle’s duration and Lin’s concordance correlation coefficient (CCC) were used to evaluate the accuracy and precision of the algorithm’s event detections. The delays in the detection were determined for each algorithm over 780 events. Analysis showed that the Hilbert and BSgonio algorithms validated the selected criteria (LoA: +5.17/−6.34% and +2.25/−2.51%, respectively), while the GCI Observer did not (LoA: +8.59/−27.89%). When evaluating control algorithms, it is paramount to define appropriate criteria in the context of the targeted practical application. To this end, normalising delays in event detection to the cycle’s duration enables the use of a criterion that stays invariable to changes in cadence. Lin’s CCC, comparing both linear correlation and strength of agreement between methods, also provides a reliable way of confirming comparisons between new control methods and an existing reference.

The purpose of this study was to examine how 14 parents of children with autism and intellectual impairments responded to an Acceptance and Commitment Therapy (ACT)-based psychological flexibility intervention programme. A randomised clinical trial was conducted. Parents were randomly assigned to the training programme group (n = 8) or waiting list group (n = 6). The treatment effect was measured using the 6-PAQ, PSS-14, GHQ-12, and WBSI questionnaires. Changes in interactions were assessed through self-recording, including a baseline to observe the previous functioning. Measures were taken before and after the application of the intervention programme and three months later. After that, the control group was switched to the psychological flexibility programme condition. After the programme’s implementation, we could see a reduction in stress and the tendency to suppress unwanted private events. The impacts also appeared to apply to family interactions, resulting in a rise in positive interactions and a decrease in unfavourable ones. The results led us to think about the importance of psychological flexibility for the parents of children with chronic conditions, facilitating a reduction in the emotional impact derived from parenting and the emission of behaviours that promote the harmonious development of the diagnosed child.

The objective of the study was to examine the relationship between psychological flexibility, perceived stress, and psychological heath in relatives of people with a disability diagnosis. 151 relatives completed an online questionnaire that included 6-PAQ (parental psychological flexibility), PSS (perceived stress), GHQ-12 (psychological health) and WBSI (suppression of unwanted thoughts). The results showed significant relationships between the four measured variables. A bimodal distribution was observed in the variables related to psychological flexibility. The multiple regression showed that difficulties in self as context, committed actions and defusion explain a high percentage of the variance of parental stress and general psychological health. The study provides new evidence to consider psychological flexibility as a mediating variable in psychological well-being. The presented data served as the basis for the development of an ACT-based intervention protocol and the implementation of a clinical trial for relatives of children with disabilities.

The objective of the study was to analyse the effect of a psychological flexibility intervention programme based on Acceptance and Commitment Therapy (ACT) on 36 family members of children with intellectual disabilities. The 6-PAQ (parental psychological flexibility), PSS-14 (perceived stress), GHQ-12 (psychological health), and WBSI (suppression of unwanted thoughts) were used as measurement instruments before the programme (pre), after (post), and at follow-up (after two months). Possible change in family interactions due to the family intervention was also assessed through self-monitoring. A decrease in psychological inflexibility, a reduction in stress, an improvement in psychological well-being, and a reduction in the tendency to suppress thoughts and emotions were observed after the programme. Furthermore, the effects seem to extend to family interactions, with an increase in positive interactions and a decrease in negative ones. The study leads us to think about the importance of psychological flexibility in children with chronic conditions as a process that mediates the impact of stress and family well-being.

This study illustrates the application of Acceptance and Commitment Therapy (ACT) for a 12-year-old boy with separation anxiety and his mother. Over 23 sessions, ACT strategies promoted psychological flexibility, values-based parenting, and adaptive behaviors. The intervention reduced the child’s experiential avoidance, anxiety, and depressive symptoms, while increasing value-oriented actions, while the mother showed improved psychological flexibility and life satisfaction. The results were sustained at a three-month follow-up. This case study highlights the potential of ACT in treating childhood separation anxiety by simultaneously involving parents, demonstrating its feasibility and efficacy. The findings provide guidance for adapting ACT for families and child populations.

Se estima el tiempo de salida de la pobreza y la tasa de crecimiento mínima necesaria para salir de ésta en un tiempo determinado, utilizando la metodología desarrollada por Chávez (2009). Los resultados muestran que los tiempos de salida, considerando una tasa de crecimiento de siete por ciento en 2010, son mayores de 50 años para las áreas urbanas, y de 98 años para las áreas rurales, mientras que la tasa mínima de crecimiento para erradicar la pobreza en el año 2050 es de nueve por ciento para las áreas urbanas y de 18.1 por ciento para las rurales.

The time it would take for urban and rural areas to exit poverty and the minimum eco- nomic growth rate to eradicate poverty in a predetermined period of time is estimated using the methodology developed by Chávez (2009). The results demonstrate that if there were an economic growth rate of seven percent beginning in 2010, the time it would take to get out of poverty for urban areas is more than 50 years, and 98 for the rural ones. The minimum rate of growth to eradicate poverty by 2050 is, for urban areas, nine percent and, for rural areas, 18.1 percent.