Test-retest reliability in performance of persons with hemiparesis tracking by means of compatibly displayed myoelectric feedback derived from upper limb muscles

The aim of this study was to assess whether persons with hemiparesis will yield statistically reliable test-retest tracking performance on a procedure using limb-generated, compatibly displayed, myoelectric video feedback. A convenience sample of 50 inpatients and outpatients with upper extremity involvement of at least six months were recruited. 30 had hemiparesis and had both upper extremities tested. 20 had hemiplegia and had the nonparetic upper extremity tested. Tracking skill was measured as mean tracking error. Repeated measures analysis of variance yielded statistically significant effects of main factors: Response mode, Cursor Feedback, and Session. Extremity tested was not significant. Performance with involved limb, uninvolved limb, isometric mode, and isotonic mode all yielded positive rest-retest correlations. The reliable range of tracking error obtained from subjects with hemiparesis performing a task requiring modulation of compatibly displayed myoelectric output supports the therapeutic rationale for employing compatibly displayed video feedback in the rehabilitation of motor control.     

The Ethical Standard of Care

The recent TeGenero phase I trial of a novel monoclonal antibody in healthy volunteers produced a drastic inflammatory reaction in participants receiving the experimental agent. Commentators on the ethics of the research have focused considerable attention on the role of financial considerations: the for-profit status of the biotechnology company and Contract Research Organization responsible respectively for sponsoring and conducting the trial and the amount of monetary compensation to participants. We argue that these financial considerations are largely irrelevant and distort ethical appraisal of this tragic research. Except for administering the antibody to all 6 participants nearly simultaneously, the trial appears to fulfill all of the critical ethical requirements for clinical research—social value, scientific validity, fair subject selection, favorable risk-benefit ratio, independent review, informed consent, and respect for enrolled participants.     

Conscience,conscientious objections,and medicine

Theoretical Medicine and Bioethics - To inform the ongoing discussion of whether claims of conscientious objection allow medical professionals to refuse to perform tasks that would otherwise be...