Differences in muscle activity during hand dexterity tasks between women with arthritis and a healthy reference group

Background. Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group. Methods. Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC. Results. The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and—for the EDC—also when writing with a pen and using a key (p < 0.02). The exercise “rolling dough with flat hands” required the lowest %MVIC and may be less effective in improving muscle strength. Conclusions. Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.

Socratic flipped classroom : What types of questions and tasks promote learning?

Socratic questioning stresses the importance of questioning for learning. Flipped Classroom pedagogy generates a need for effective questions and tasks in order to promote active learning. This paper describes a project aimed at finding out how different kinds of questions and tasks support students’ learning in a flipped classroom context. In this study, during the flipped courses, both the questions and tasks were distributed together with video recordings. Answers and solutions were presented and discussed in seminars, with approximately 10 participating students in each seminar. Information Systems students from three flipped classroom courses at three different levels were interviewed in focus groups about their perceptions of how different kinds of questions and tasks supported their learning process. The selected courses were organized differently, with various kinds of questions and tasks. Course one included open questions that were answered and presented at the seminar. Students also solved a task and presented the solution to the group. Course two included open questions and a task. Answers and solutions were discussed at the seminars where students also reviewed each other’s answers and solutions. Course three included online single- and multiple choice questions with real-time feedback. Answers were discussed at the seminar, with the focus on any misconceptions. In this paper we categorized the questions in accordance with Wilson (2016) as factual, convergent, divergent, evaluative, or a combination of these. In all, we found that any comprehensible question that initiates a dialogue, preferably with a set of Socratic questions, is perceived as promoting learning. This is why seminars that allow such questions and discussion are effective. We found no differences between the different kinds of Socratic questions. They were seen to promote learning so long as they made students reflect and problematize the questions. To conclude, we found that questions and tasks promote learning when they are answered and solved in a process that is characterized by comprehensibility, variation, repetition and activity.