Publications by authors named "K Bo Foreman"

237 Publications

The feasibility and efficacy of a serial reaction time task that measures motor learning of anticipatory stepping.

Gait Posture 2021 May 7;86:346-353. Epub 2021 Apr 7.

Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA.

Background: Motor learning has been investigated using various paradigms, including serial reaction time tasks (SRTT) that examine upper extremity reaching and pointing while seated. Few studies have used a stepping SRTT, which could offer additional insights into motor learning involving postural demands. For a task to measure motor learning, naïve participants must demonstrate a) improved performance with task practice, and b) a dose-response relationship to learning the task.

Research Question: Is a stepping SRTT feasible and efficacious for measuring motor learning?

Methods: In this prospective study, 20 participants stood on an instrumented mat and were presented with stimuli on a computer screen. They stepped to the corresponding positions on the mat as quickly as possible. Presented stimuli included random sequences and a blinded imbedded repeating sequence. Three days after completing the randomly assigned practice dose [high dose group (n = 10) performed 4320 steps; low dose group (n = 10) performed 144 steps], a retention test of 72 steps was performed. Feasibility was measured as the proportion of participants who completed the assigned practice dose without adverse events. Efficacy was measured as within-group performance improvement on the random sequences and on the repeating sequence (paired t-tests), as well as a dose-response relationship to learning both types of sequences (independent t-tests).

Results: All participants (mean age 26.8 years) completed all practice sessions without adverse events, indicating feasibility. High dose practice resulted in performance improvement while low dose did not; a dose-response relationship was found, with high dose practice resulting in greater learning of the task than low dose practice, indicating efficacy.

Significance: This stepping SRTT is a feasible and efficacious way to measure motor learning, which could provide critical insights into anticipatory stepping, postural control, and fall risk. Future research is needed to determine feasibility, efficacy, and optimal practice dosages for older and impaired populations.
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May 2021

The modified Shriners Hospitals for Children Greenville (mSHCG) multi-segment foot model provides clinically acceptable measurements of ankle and midfoot angles: A dual fluoroscopy study.

Gait Posture 2021 Mar 13;85:258-265. Epub 2021 Feb 13.

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, United States; Department of Biomedical Engineering, University of Utah, 72 Central Campus Dr, Salt Lake City, UT 84112, United States; Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Suite 240, Salt Lake City, UT 84108, United States; Scientific Computing and Imaging Institute, University of Utah, 72 Central Campus Dr, Salt Lake City, UT 84112, United States. Electronic address:

Background: Several multi-segment foot models have been developed to evaluate foot and ankle motion using skin-marker motion analysis. However, few multi-segment models have been evaluated against a reference standard to establish kinematic accuracy.

Research Question: How accurately do skin-markers estimate foot and ankle motion for the modified Shriners Hospitals for Children Greenville (mSHCG) multi-segment foot model when compared against the reference standard, dual fluoroscopy (DF), during gait, in asymptomatic participants?

Methods: Five participants walked overground as full-body skin-marker trajectory data and DF images of the foot and shank were simultaneously acquired. Using the mSHCG model, ankle and midfoot angles were calculated throughout stance for both motion analysis techniques. Statistical parametric mapping assessed differences in joint angles and marker positions between skin-marker and DF motion analysis techniques. Paired t tests, and linear regression models were used to compare joint angles and range of motion (ROM) calculated from the two techniques.

Results: In the coronal plane, the skin-marker model significantly overestimated ROM (p = 0.028). Further, the DF model midfoot ROM was significantly positively related to differences between DF and skin-marker midfoot angles (p = 0.035, adjusted R = 0.76). In the sagittal plane, skin-markers underestimated ankle angles by as much as 7.26°, while midfoot angles were overestimated by as much as 9.01°. However, DF and skin-marker joint angles were not significantly different over stance. Skin-markers on the tibia, calcaneus, and fifth metatarsal had significantly different positions than the DF markers along the direction of walking for isolated portions that were less than 10 % of stance. Euclidean distances between DF and skin-markers positions were less than 9.36 mm.

Significance: As the accuracy of the mSHCG model was formerly unknown, the results of this study provide ranges of confidence for key angles calculated by this model.
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March 2021

Developing a Breast Reconstruction Program in a Resource-Constrained Ghanaian Teaching Hospital: Needs Assessment and Implementation.

Ann Plast Surg 2021 02;86(2):129-131

From the Division of Plastic Surgery, University of Utah Health Sciences Center, Salt Lake City, UT.

Abstract: As the detection of breast cancer in Ghana improves, the incidence of mastectomy has increased and the outcomes have improved. As a secondary result, the need for breast reconstruction is increasing. The cultural hesitation to undergo a mastectomy and live without a breast can be decreased by making breast reconstruction available, cost-effective, and acceptable. Cultural, economic, and technical factors were considered in choosing the best method of breast reconstruction. Discussions, lectures, and cadaver dissections investigated the various reconstructive options. Operative cases were performed using a latissimus musculocutaneous flap, a lower abdominal transverse rectus abdominis myocutaneous (TRAM) flap, and a midabdominal TRAM flap. The midabdominal TRAM was found to be the best choice at Komfo Anokye Teaching Hospital. It is a reliable, robust, well-perfused, single-stage flap that produced excellent patient satisfaction.
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February 2021

Single-Molecule Tracking in Poly(Ethylene Oxide) Films: Revealing the Effects of Molecular Weight, Network Plasticization, and Thermal Annealing on Anionic Dye Diffusion.

J Phys Chem B 2021 01 5;125(1):382-392. Epub 2021 Jan 5.

Department of Chemistry, Towson University, Towson, Maryland 21252, United States.

This paper reports single-molecule tracking (SMT) measurements of the diffusion behaviors of individual, anionic sulforhodamine B (SRB) dye molecules in a series of poly(ethylene oxide) (PEO) films, aimed at clarifying the influences of the molecular weight, network plasticization, and thermal annealing on such dynamics. Micrometer-thick PEO films were prepared by drop-casting from its aqueous (0.2%, 1 nM SRB) solution, followed by drying in air and thermal annealing at 90 °C for 36 h. The diffusion of individual SRB occurring within the amorphous domains was recorded at different relative humidities (5-95%) to characterize the microscale domains' local aspect-ratio, orientation, and molecular permeability at high spatial resolution. The results revealed the involvement of crystalline phases in confining SRB diffusion to submicron distances and guiding longer-range diffusion along one-dimensional-like amorphous morphologies. Upon annealing, amorphous domains were wider, more continuous, and more permeable to SRB probes. The enhanced transport in plasticized PEO, as reflected by the higher SRB mobility and diffusivity, was linked to the polymer's higher chain and segmental mobilities and reduced hydrogen-bonding interactions. This work has demonstrated the usefulness of SMT for an advanced characterization of solid polymer electrolytic films, highly beneficial for the development of safer lithium-ion batteries.
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January 2021

Changes in Step Characteristics Over a Known Outdoor Surface Transition: The Effect of Parkinson Disease.

J Appl Biomech 2020 Dec 6;37(1):59-65. Epub 2020 Dec 6.

University of Utah.

The factors that contribute to the difficulties persons with Parkinson Disease (PwPD) have when negotiating transitions in walking surfaces are not completely known. The authors investigated if PwPD adjusted their step characteristics when negotiating a familiar outdoor surface transition between synthetic concrete and synthetic turf. Force plate and motion capture data were collected for 10 participants with mild to moderate Parkinson disease and 5 healthy older control participants ambulating bidirectionally across the transition between synthetic concrete and synthetic turf. Between groups, PwPD had a significantly higher minimum toe clearance (P = .007) for both directions of travel compared with the healthy control group. Within groups, PwPD significantly increased their hip (P < .001) and ankle (P = .016) range of motion walking from concrete to turf, while the healthy control participants significantly increased their minimum toe clearance (P = .013), margin of stability (P = .019), hip (P < .001) and ankle (P = .038) range of motion, and step length (P < .001). Walking from turf to concrete, both the Parkinson disease group (P = .014) and the healthy control group (P < .001) increased their knee range of motion. Both groups adjusted their step characteristics when negotiating known surface transitions, indicating that surface transitions result in step changes regardless of health status. However, PwPD exhibited overcompensations, particularly in their minimum toe clearance.
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December 2020