(2) Does the contextual learning approach improve the students' critical thinking ability in comparison with the conventional approach in the WIQ environment?
(3) Does the contextual learning approach improve the students' learning attitudes in comparison with the conventional approach in the WIQ environment?
Web-based issue quest (WIQ) refers to the learning activities that engage students in utilizing web information in an organized and meaningful manner for investigating or answering a series of questions related to a specified issue (Cheng, Liang, & Tsai, 2013; Mason, Ariasi, & Boldrin, 2011; Tsai & Tsai, 2010), and has been recognized as an essential skill for adapting to the environment (Geger, 2014).
For example, Kanuka, Rourke and Laflamme (2007) reported several advantages of WIQ activities, including engaging students in structuring the collected information and providing them with the opportunity to identify their roles and responsibilities during the learning process.
Interestingly, in both the nondepressed and depressed patients, moderate relationships were identified between the 6-minute walk distance and the number of stairs climbed and descended, as well as between the WIQ subscales and the SF-36 Physical Composite scores.
Abbreviations: BMI = body mass index, CES-D = Center for Epidemiologic Studies Depression Scale, OA = osteoarthritis, SF-36 = 36-Item Short Form Health Survey, WIQ = Walking Impairment Questionnaire, WOMAC = Western Ontario and MacMaster Universities (Osteoarthritis Index).
CES-D Variable r-Value p-Value Age (yr) -0.35 0.001 Duration of OA (yr) 0.20 0.20 Kellgren-Lawrence -0.06 0.45 Classification (Kendall's [tau]) Coexisting Diseases (n) 0.34 <0.001 BMI (kg/[m.sup.2]) 0.13 0.10 WOMAC Function 0.54 <0.001 WOMAC Stiffness 0.26 0.004 WOMAC Pain 0.43 <0.001 WIQ Total Score -0.46 <0.001 SF-36 Physical Composite Score -0.28 0.002 6-Minute Walk (distance [m]) -0.17 0.04 3-Minute Stair Climb and Descend -0.14 0.07 (stairs [No.]) BMI = body mass index, CES-D = Center for Epidemiologic Studies Depression Scale, OA = osteoarthritis, SF-36 = 36-Item Short Form Health Survey, WIQ = Walking Impairment Questionnaire, WOMAC = Western Ontario and MacMaster Universities (Osteoarthritis Index).
While we used standard measuring tools for quantitative and qualitative measures of study outcomes, we also tested the participants' perceptions of their walking ability using the WIQ.
The WIQ was self-administered according to study protocol at baseline, 16, 24, and 32 weeks.
The WIQ is a subjectively measured, self-administered instrument consisting of a 14-item survey with three subscales: walking distance (7 items), walking speed (4 items), and stair-climbing ability (3 items).
The WIQ measures an individual's mobility and degree of difficulty in performing the tasks.
Abbreviations: ACSM = American College of Sports Medicine, ADL = activities of daily living, BMI = body mass index, CVD = cardiovascular disease, ECG = electrocardiogram, HR = heart rate, HRR = HR reserve, IGT = impaired glucose tolerance, MHC = myosin heavy chain, T2DM = type 2 diabetes mellitus, TM = treadmill, TNF-[alpha] = tumor necrosis factor-[alpha], WIQ
= Walking Impairment Questionnaire, VA = Department of Veterans Affairs, V[O.sub.2] = peak oxygen consumption.