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| Toward a Role of Behavior Analysis in Physical Rehabilitation |
| Sunday, May 28, 2023 |
| 8:00 AM–9:50 AM |
| Hyatt Regency, Centennial Ballroom D |
| Area: EAB; Domain: Translational |
| Chair: J. Logan Gibson (University Of North Texas) |
| Discussant: Rogelio Escobar (National Autonomous University of Mexico) |
| CE Instructor: Brennan Patrick Armshaw, Ph.D. |
| Abstract: The effectiveness of Applied Behavior Analysis (ABA) derives from the ability of behavioral scientists to isolate socially-relevant behavior of interest and to create artificial behavior-environment interactions in support of that behavior. In simpler and more familiar terms, our prowess derives from our ability to create contingencies of reinforcement and establish stimulus control. As such, the scope of ABA is limited only by what we are able to measure and our ability to embed that information into a systematic protocol of feedback. Each of the four talks in this symposium use surface electromyographs to measure the electrical activity of muscles. This information is used to create contingencies of reinforcement to support the development of muscle strength. The first talk will present data on the rehabilitation of the knee in a clinical context. The second talk will present data on the use of conjugate schedules to drive muscle strength. The third talk will present data on a comparison between active and passive muscle training protocols. Finally, the fourth talk will present data on the rehabilitation of the pelvic floor by reinforcing activation of a correlated set of muscles. Taken together, these studies can help contribute to the expansion of the scope of ABA. |
| Instruction Level: Intermediate |
| Keyword(s): contingent feedback, dissemination, physical rehabilitation, reinforcement modalities |
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The Heart of a Flexible Science of Behavior: Expanding Our Scope Examples From Physical Therapy |
| (Applied Research) |
| BRENNAN PATRICK ARMSHAW (West Virginia University ), Manish Vaidya (University of North Texas) |
| Abstract: The flexible nature of the science of behavior lends itself to diverse applications. However, in practice, bringing the science to bear across different domains often proves challenging. The fields of medicine and physical therapy are no exception to this challenge of domain bridging. Despite these obstacles, there is a growing need for behaviorally informed approaches to health and wellness. This presentation describes a series of works centered around recovery from total knee replacement. The aim of this presentation is four-fold. First, outline a behavioral approach to asking questions that are commonly considered medical in nature. Second, describe considerations when approaching intradisciplinary collaboration and employing a patient-centered care model of applied research. Third, discuss the importance of balancing the considerations made for empirical research and those for patient quality of life as an applied researcher. Finally, present translational and applied data supporting the utility and importance of expanding the application of our science to diverse areas, such as physical therapy. |
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| Conjugate Reinforcement of Muscle Contractions Using Surface Electromyography |
| (Applied Research) |
| MATTHEW NGUYEN (University of North Texas), Russell Silguero (University of North Texas), Manish Vaidya (University of North Texas) |
| Abstract: Biofeedback has been shown to be an effective strategy for training or retraining neuromuscular responses. The strategy arranges for environmental feedback, such as a brief sound, following a response that meets certain pre-established criteria such as intensity of the response. One particular kind of biofeedback strategy is called a conjugate schedule. In conjugate schedules, parameters of the feedback (such as amount of stimulation) are related in some fashion to parameters of the response (such as intensity) such that a more intense response produces greater feedback than a less intense response. These arrangements have been shown to improve upon the effects of more standard biofeedback arrangements. In the proposed study, we wish to explore the nature of the relationship between response and feedback. Specifically, we ask if a curvilinear relation between response and reinforcement parameters will be more effective than the linear relation that is typically arranged between response and reinforcement. |
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| Tracking the Effects of Active and Passive Training on Muscle Strength |
| (Applied Research) |
| ALEXANDRA ZACHARY SMITH (University of North Texas), Brennan Patrick Armshaw (West Virginia University ), Manish Vaidya (University of North Texas) |
| Abstract: Total Knee Arthroplasty (TKA) procedures are performed on over a million adult patients per year in the U.S, and sometimes up to twice in the same year for some patients due to the effect of severe Osteoarthritis in both of their knees. Physical therapy aids recovery in the knee post-surgery by strengthening the Vastus Medialis Oblique (VMO) muscle. The current standard in physical therapy is the application of neuromuscular stimulation (NMES) to passively contract the muscle. However, results from our lab sEMGBF) is more effective as an intervention to strengthen the VMO in comparison to NMES. The current study sought to track the development of VMO muscle strength across a patient’s time in a rehabilitation clinic. In particular, we compared the development of muscle strength following active training via sEMGBF and after passive training via NMES. The data appear to replicate the patterns seen earlier in that participants receiving NMES gained muscle strength slower than participants receiving sEMGBF. The data presented below present the findings from an earlier study with the same goal. |
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| Investigating Operant Control of the Pelvic Floor Muscles in the Context of a Surface Electromyography Informed Feedback Protocol |
| (Applied Research) |
| J. LOGAN GIBSON (University of North Texas), Manish Vaidya (University of North Texas) |
| Abstract: Urinary incontinence (UI) is a life-altering condition in which urine can leak due to physical stress, such as standing, lifting heavy objects, or sneezing. Risk factors that lead to UI are varied, but one common proximal cause is the weak pelvic floor muscles (PFM) that control urine retention. These muscles can be strengthened by exercise; however, current rehabilitation protocols are invasive, expensive, and have low acceptability. Furthermore, the anatomical structure of the PFM is such that little naturally occurring feedback is present even when contracting the muscle properly. In the case of total knee arthroplasty, our lab has investigated the use of surface-electromyography (sEMG) to measure the performance of the vastus medialis oblique while using audiovisual feedback to reinforce responding, contingent upon meeting prespecified criteria. Similarly, in the present study, we used sEMG to measure the PFM via two co-contracting muscles – the Transverse Abdominus (TrA) and the Internal Oblique (IO) while providing contrived consequences when participant responses met criteria. Early results suggest that the amplitude of activation of the TrA/IO site is sensitive to consequences. Orderly data from this study may have clinical implications for PFM rehabilitation in the future. |
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