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- Creators: Arizona Board of Regents
- Creators: Barrett, The Honors College
- Creators: Holzapfel, Simon
Description
Twilight Sleep was a technique originally developed by physicians in Germany in the early 20th century as a novel way to address parturient women’s fear and aversion to pain endured during labor and childbirth. Using a combination of amnestic and analgesic agents such as scopolamine and morphine to synergistically suppress pregnant women’s memories, physicians Carl Gauss and Bernhard Krönig enabled women to give birth free of pain, or more accurately any memories of pain.
Despite widespread use throughout Europe, Twilight Sleep initially experienced less popularity and more resistance in the United States where doctors were wary of the potential health risks that Twilight Sleep brought upon women and infants. Some adverse effects caused by incorrect doses of scopolamine and morphine included hallucinations and uncontrolled thrashing in women and depressed respiration in infants. Thus, Twilight Sleep’s status as a vogue topic in obstetrics during the first half of the 20th century came about due to the work of affluent and educated American women. While lacking formal medical training, a subset of women became experts in the matter of Twilight Sleep by traveling to Germany to experience and investigate Twilight Sleep firsthand then disseminating their findings through published books and articles.
This thesis explores the impact of Twilight Sleep on women and physicians and their perceptions of childbirth. Twilight Sleep empowered women to take on a more active role in shaping the medical care they received rather than accepting that childbirth as a natural event associated with physical and mental trauma and high risk of mortality. For doctors, the debate regarding Twilight Sleep’s safety and efficacy affirmed a ubiquitous notion that childbirth ought to be seen as a pathological rather than natural event. By considering childbirth a medical condition that necessitated treatment, physicians had to evaluate their duties to their patients. In empowering women to be involved in making medical decisions and forcing physicians to balance their medical training with their patients’ needs, Twilight Sleep helped to establishing more reciprocal doctor-patient relationships.
Despite widespread use throughout Europe, Twilight Sleep initially experienced less popularity and more resistance in the United States where doctors were wary of the potential health risks that Twilight Sleep brought upon women and infants. Some adverse effects caused by incorrect doses of scopolamine and morphine included hallucinations and uncontrolled thrashing in women and depressed respiration in infants. Thus, Twilight Sleep’s status as a vogue topic in obstetrics during the first half of the 20th century came about due to the work of affluent and educated American women. While lacking formal medical training, a subset of women became experts in the matter of Twilight Sleep by traveling to Germany to experience and investigate Twilight Sleep firsthand then disseminating their findings through published books and articles.
This thesis explores the impact of Twilight Sleep on women and physicians and their perceptions of childbirth. Twilight Sleep empowered women to take on a more active role in shaping the medical care they received rather than accepting that childbirth as a natural event associated with physical and mental trauma and high risk of mortality. For doctors, the debate regarding Twilight Sleep’s safety and efficacy affirmed a ubiquitous notion that childbirth ought to be seen as a pathological rather than natural event. By considering childbirth a medical condition that necessitated treatment, physicians had to evaluate their duties to their patients. In empowering women to be involved in making medical decisions and forcing physicians to balance their medical training with their patients’ needs, Twilight Sleep helped to establishing more reciprocal doctor-patient relationships.
ContributorsTran, Yvette Ho (Author) / Maienschein, Jane (Thesis director) / Hurlbut, Ben (Committee member) / O'Neil, Erica (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
This study examines the effectiveness of two modes of exercise on self-efficacy (SE) in adolescents with Down syndrome (DS). Thirty-nine participants were randomly divided into a voluntary cycling group (VC) (i.e., self-selected cadence), an assisted cycling group (ACT) (i.e., at least 30% faster than self-selected cadence accomplished by a motor), or a no exercise group (NC). In each cycling intervention the participant completed 30 minute cycling sessions, three times per week for a total of eight weeks. Two subsets of the Physical Activity and Self Efficacy Survey were administered prior to cycling (i.e., pretest) and after the eight week intervention (i.e., post-test). The results were consistent with the hypothesis that self-efficacy would improve after ACT, however there was not improvement after the VC condition as hypothesized. It was also hypothesized that exercise perception would improve following the ACT intervention; execise perception showed a trend of improvement after ACT, but the data did not reach significance. Limitations include the wide variability of the DS population. This limitation is responsible for the variation in mental age seen in the intervention groups and could be responsible for the non-significance of the exercise perception data. To generalize our results for parents, therapists, teachers, etc., our recommendation is for persons with DS to participate in physical activity that is easy for them at first \u2014 a simplified sport or active game, assisted cycling, brisk walking \u2014 so that they have a positive experience with exercise. Showing individuals with DS that they can be proficient exercisers will likely improve their self-efficacy and motivate them to engage in more PA over time. In conclusion, eight weeks of moderate ACT exercise demonstrated a significant trend for improved self-efficacy in adolescents with DS.
ContributorsWallace, Kellie Carter (Author) / Ringenbach, Shannon (Thesis director) / Youngstedt, Shawn (Committee member) / Hoffner, Kristin (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12
Description
The purpose of this paper was to review existing literature on exercise interventions to improve postural stability in older adults in order to assist with the development of a novel intervention with the same function. A brief review of balance changes with aging is followed by a summary of the methods and findings of various interventions. Many types of interventions are discussed, including resistance training, balance training, t'ai chi, and whole body vibration. The studies show promising results, but none utilize the approach of the proposed intervention. This intervention being developed involves the use of a weighted vest to raise one's center of mass, creating a more unstable posture. Performing exercises or daily activities with the vest may improve balance by training muscles in unsteady conditions. The intervention principles to improve postural stability in older adults are beneficial to the foundation of future studies.
ContributorsWiedemann, Ava Marie (Author) / Dounskaia, Natalia (Thesis director) / Ringenbach, Shannon (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor) / School of International Letters and Cultures (Contributor)
Created2014-12
Description
The influence of exercise on cognitive function is an important topic. This study examines the effects of different interventions on executive functioning, specifically on cognitive planning, which is a sub-category of executive function, in adults with Down syndrome. Research has shown that an acute bout of Assisted Cycle Therapy improved manual motor functioning, cognitive planning, and information processing in adolescents with Down syndrome but there is a lack of research when it comes to resistance training. Fourteen adults with Down syndrome completed acute sessions of Assisted Cycle Therapy, Resistance Training, and No Training. Cognitive planning was measured by the Tower of London test. The results show that cognitive planning can be improved following Assisted Cycle Therapy. An increase in cognitive planning was also present in the No Training group which may be a result of cognitive stimulating games that were played. In conclusion, this study suggests that teachers, therapists, etc. that work with adults with DS, should be sure to include a cognitive component in all activities.
ContributorsMyer, Brandon Michael (Author) / Ringenbach, Shannon (Thesis director) / Arnold, Nathanial (Committee member) / Morgan, Don (Committee member) / College of Health Solutions (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Down syndrome (DS) is caused by either an extra copy of chromosome 21 or by extra material on chromosome 21. This causes various levels of intellectual disability and issues with gross motor skill development which can prevent these individuals from participating in activities of daily living (ADL) such as getting dressed, self-care, or grocery shopping. People with DS have a decreased ability to balance, an abnormal and slower gait pattern, difficulty adapting to new environments, and a lack of improvement in these areas with growth and development when compared to their neurotypical peers. The objective of this study was to determine the immediate effects of resistance training (RT) and assisted cycle therapy (ACT) on adults with DS’s balance ability and gait speed. Each participant completed one session of RT, ACT (stationary cycling with the assistance of a motor to maintain a cadence of at least 35% greater than their voluntary cycling speed), and no training in a randomly selected order. Balance and gait speed were measured by a Clinical Test of Sensory Interaction on Balance (CTSIB) (i.e., eyes open firm surface, eyes closed firm surface, eyes open foam surface, eyes closed foam surface) on a Balance Tracking System Board (Btracks board) and by a Timed Up and Go (TUG) test. A total of ten participants’ data was used for analysis. The measures of total path length (cm), anterior-posterior (AP) excursion, and medial-lateral (ML) excursion were used to analyze the CTSIB. The average time was used to analyze the TUG test. The results showed that the eyes closed foam surface balance task was the most challenging balance task for every participant in every intervention. Furthermore, the most improvement was evident in the eyes closed foam surface balance task from pre to post intervention in all of the interventions. Post hoc tests also indicated statistically significant improvements of path length from pre to post in the RT intervention with the eyes closed foam surface balance task as well as with AP excursion in the ACT intervention with the eyes closed foam surface balance task. Possible explanations for improvements from pre to post in the eyes closed foam balance task across all interventions will be discussed with respect to the length of the intervention, and the effect of strength, social and learned factors on balance in adults with DS.
ContributorsKeim, Jeannette Danielle (Author) / Ringenbach, Shannon (Thesis director) / Peterson, Daniel (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
Description
Down syndrome (DS), which is determined by an extra 21 chromosome, is one of the most common developmental disabilities across all races and societies. One of the hallmarks of people with DS is that they have deficits in cognitive control compared with their peers. In addition to broad cognitive impairment, persons with DS have physical characteristics which limit their ability to perform activities of daily living (ADL) including deficits in fine motor control needed for handling money, self-care, eating, etc. As the relative prevalence of DS at birth lessens, and as life expectancy increases, DS will be most commonly represented amongst the elderly. Thus, intervention is needed in older adults with DS to improve their manual dexterity to sustain their independence and quality of life. The aim of this study was to examine the influence of Assisted Cycling Therapy (ACT) compared to voluntary cycling (VC) and no cycling (NC) on fine motor control in older adults with Down Syndrome (DS). Twenty-five older adults with DS were randomly assigned to one of three, 30 minute interventions, which took place over an eight-week period of time. 1) Thirteen older adults with DS completed the ACT intervention, which is stationary cycling with the assistance of a motor to maintain a cadence at least 35% greater than voluntary cycling. 2) Ten older adults with DS completed voluntary cycling (VC) and 3) Two older adults with DS were in our no cycling (NC) intervention. Fine motor control was measured with the Purdue Pegboard placing pegs in small holes in 30 s with the right hand alone, the left hand alone, and bimanually pre and post 8 weeks of intervention. Our results showed that bimanual and total score (i.e., right, left and bimanually) fine motor control improved following both ACT and VC cycling exercise but not NC. This suggests that 30 minutes of exercise over 8 weeks has some positive effects on manual dexterity. Different mechanisms for this improvement will be discussed. This information is important to the independence and quality of life of older adults with DS.
ContributorsMendoza, Ezekiel Arceo (Author) / Ringenbach, Shannon (Thesis director) / Ofori, Edward (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
There has been very little research conducted on the long-term effects of exercise on children with Down Syndrome (DS), however, there is some research on Assisted Cycle Therapy (ACT) in adolescents and adults with Down Syndrome and has found positive results on motor, cognitive and mental health measure. Therefore, a grant proposal was submitted to develop ACT Early, a pediatric version of the ACT bicycle, developed in conjunction with Theracycle, geared towards early intervention in children with DS rather than adults with DS. Once submitted, the reviewers sent back their comments of why they would not fund the development of ACT Early. The comments focused on what the parents/guardians would want for their children. Therefore, the purpose of this thesis was to create a questionnaire for parents/guardians so a new grant proposal can be created based on their input and to find the effects exercise and ACT has on children with Down Syndrome. After weeks of helping create the survey based on comments from reviewers of the previously submitted grant, I collected 70 questionnaires at several events in the community. Our results showed that the exercise regimen would be most appropriate for 7-9 year old’s for 2 days a week and 30-45 min per day. The type of exercise would be light intensity on an ACT Theracycle, and it will be done in a fitness/clinical setting. Other options that were suggested were to add music or a buddy to exercise with. Additionally, straps will be used on the Theracycle to ensure maximum safety and the results will be disseminated via emails, websites, in person and through journals. In conclusion, the hope is that the changes made to the study based on this survey of parent/guardian input will help fund the development of the ACT Early Theracycle for children. This is important because early intervention in children with neurological disorders can achieve their best quality of life as soon as possible and become independent, happy, and productive in our society.
ContributorsSpeckler, Rachelle Laura (Author) / Ringenbach, Shannon (Thesis director) / Simon, Holzapfel (Committee member) / College of Health Solutions (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
This study examines the effectiveness of two modes of exercise on self-efficacy (SE) and exercise perception (EP) in adults with Down syndrome (DS). Thirteen participants attended four sessions: a baseline assessment, an Assisted Cycling Therapy (ACT) session, a resistance training (RT) session, and a session of no training (NT). In the baseline assessment, 1-repetition max (1RM) measurements and voluntary pedal rate measurements were taken. In the cycling intervention, the participant completed 30 minutes of assisted cycling at 35 percent greater than their voluntary pedaling rate. In the resistance training session, 2 sets of 8-12 repetitions of the leg press, chest press, seated row, leg curl, shoulder press, and latissimus pulldown were performed. During the session of no training, participants played board games with student researchers for 35 minutes.Two subsets of the Physical Activity and Self Efficacy Survey were administered prior to each session (i.e., pretest) and after the intervention (i.e., post-test). The results were consistent with the hypothesis that ACT would lead to higher SE than RT or NT. However, ACT did not lead to higher EP than RT or NT as hypothesized. Additionally, it was hypothesized that RT would lead to higher SE and EP than NT, but the results did not support this. In conclusion, an acute session of ACT demonstrated a significant trend for improved self-efficacy in adults with DS.
ContributorsOberbillig, Nicole (Author) / Ringenbach, Shannon (Thesis director) / Ofori, Edward (Committee member) / School of International Letters and Cultures (Contributor) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
The aim of this study was to examine the influence of Assisted Cycling Therapy (ACT) on information processing measured by simple reaction time in older adults with Down Syndrome (DS). Twenty-one participants were randomly assigned to one of three interventions over eight weeks. 1) Eleven older adults with Down Syndrome completed the ACT intervention, which is stationary cycling with the assistance of a motor to maintain a cadence at least 35% greater than voluntary cycling. 2) Eight older adults with Down Syndrome completed the voluntary cycling (VC) intervention and 3) two older adults with Down Syndrome were in our no cycling (NC) intervention. Both exercise groups participated in the eight-week, supervised exercise protocol for at least three, 30-minute sessions per week. None of our results reached conventional levels of significance. However, the greatest improvements in reaction time occurred following the voluntary cycling (VC) intervention. Our results are discussed with respect to physiological differences in older adults with DS that may limit improvements in executive function following exercise. These physiological differences and limitations include muscle atrophy and reduced perceptions, age related latency between motor cortex activation and onset of muscle activity, as well as general age related slowing in reaction time. Although it may be difficult to improve executive function in older adults with DS, we suggest other benefits to exercise which include improving social communication, gross motor skills, and exercise perception. Future research should continue to investigate the effects of exercise on multiple areas in older adults with DS with the hopes of improving quality of life.
ContributorsCahill, Colleen Mary (Author) / Ringenbach, Shannon (Thesis director) / Amazeen, Eric (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The aim of this study was to examine the effects of Assisted Cycle Therapy (ACT) on self-efficacy and exercise perception in older adults with Down syndrome (DS) after a three times a week for 8 weeks intervention. Thirteen participants were in the ACT group in which a motor assisted their cycling to be performed at least 30% faster than voluntary cycling (VC), 11 participants were in the voluntary cycling group and two participants were in the no cycling (NC) group. The results showed that both exercise groups (i.e., ACT and VC) improved in their self-efficacy after the 8 week intervention. In addition, exercise perception improved following ACT and not VC or NC. Our results are discussed with respect to their future implications for exercise in the DS population. It might be that the yielded results were due to differences in effort required by each intervention group as well as the neurotrophic factors that occur when muscle contractions create synaptic connections resulting in improvement in cognition and feelings of satisfaction. In the future, research should focus on the psychological factors such as social accountability and peer interaction as they relate to ACT and physical activity in person's with DS.
ContributorsTucker, Kori Ann (Author) / Ringenbach, Shannon (Thesis director) / Arnold, Nathaniel (Committee member) / Holzapfel, Simon (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05