Effectiveness of joint mobilisation after cast immobilisation for ankle fracture: a protocol for a randomised controlled trial [ACTRN012605000143628]

BACKGROUND: Passive joint mobilisation is a technique frequently used by physiotherapists to reduce pain, improve joint movement and facilitate a return to activities after injury, but its use after ankle fracture is currently based on limited evidence. The primary aim of this trial is to determine if adding joint mobilisation to a standard exercise programme is effective and cost-effective after cast immobilisation for ankle fracture in adults. METHODS/DESIGN: Ninety participants will be recruited from the physiotherapy departments of three teaching hospitals and randomly allocated to treatment or control groups using a concealed procedure. All participants will perform an exercise programme. Participants in the treatment group will also receive joint mobilisation twice a week for four weeks. Blinded follow-up assessments will be conducted four, 12 and 24 weeks after randomisation. The primary outcome measures will be the Lower Extremity Functional Scale and the Assessment of Quality of Life. Secondary outcomes will include measures of impairments, activity limitation and participation. Data on the use of physiotherapy services and participants' out-of-pocket costs will be collected for the cost-effective and cost-utility analyses. To test the effects of treatment, between-group differences will be examined with analysis of covariance using a regression approach. The primary conclusions will be based on the four-week follow-up data. DISCUSSION: This trial incorporates features known to minimise bias. It uses a pragmatic design to reflect clinical practice and maximise generalisability. Results from this trial will contribute to an evidence-based approach for rehabilitation after ankle fracture

Train speed estimations from ground vibration measurements using a simple rail deflection model mask

The speed of passing trains is conventionally estimated using Doppler speed guns, or optical sensors. However in many cases, these techniques are not applicable when the measured trains are not visible (for example in tunnels) or close access to the track is not possible. An alternative method to estimate train speed from ground vibration measurements is presented in this paper. The method takes advantage of the relation between vibration levels and the cyclic repetition of the excitation forces created by the wheels. A train mask, expressed in the wavelength domain, is derived from a simple rail deflection model induced by the train wheels. The vibration spectrum at very low frequency and the train mask are qualitatively compared to match the various peaks. Vibration and train speed measurements have been undertaken near St Denys station, Southampton. Very good agreements have been observed between the direct train speed measurements and the proposed estimation method.</p