Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis

Background Both increased knee muscle co-contraction and alterations in central pain processing have been suggested to play a role in knee osteoarthritis pain. However, current interventions do not target either of these mechanisms. The Alexander Technique provides neuromuscular re-education and may also influence anticipation of pain. This study therefore sought to investigate the potential clinical effectiveness of the AT intervention in the management of knee osteoarthritis and also to identify a possible mechanism of action. Methods A cohort of 21 participants with confirmed knee osteoarthritis were given 20 lessons of instruction in the Alexander Technique. In addition to clinical outcomes EMG data, quantifying knee muscle co-contraction and EEG data, characterising brain activity during anticipation of pain, were collected. All data were compared between baseline and post-intervention time points with a further 15-month clinical follow up. In addition, biomechanical data were collected from a healthy control group and compared with the data from the osteoarthritis subjects. Results: Following AT instruction the mean WOMAC pain score reduced by 56% from 9.6 to 4.2 (P<0.01) and this reduction was maintained at 15 month follow up. There was a clear decrease in medial co-contraction at the end of the intervention, towards the levels observed in the healthy control group, both during a pre-contact phase of gait (p<0.05) and during early stance (p<0.01). However, no changes in pain-anticipatory brain activity were observed. Interestingly, decreases in WOMAC pain were associated with reductions in medial co-contraction during the pre-contact phase of gait. Conclusions: This is the first study to investigate the potential effectiveness of an intervention aimed at increasing awareness of muscle behaviour in the clinical management of knee osteoarthritis. These data suggest a complex relationship between muscle contraction, joint loading and pain and support the idea that excessive muscle co-contraction may be a maladaptive response in this patient group. Furthermore, these data provide evidence that, if the activation of certain muscles can be reduced during gait, this may lead to positive long-term clinical outcomes. This finding challenges clinical management models of knee osteoarthritis which focus primarily on muscle strengthening

'The brede of good & strong Horsis': zooarchaeological evidence for size change in horses from early modern London

Almost 200 horse bone measurements from 38 sites excavated across the city of London, dating to the period AD 1220–1900 were analysed. Results identified three main phases of size change: a reduction in size in the mid 14th to 15th century, and size increases in the mid 15th to 16th century and the 17th century. The decline in size testifies to the disruption of horse breeding in the wake of the Black Death, whilst the increases reflect purposeful attempts to increase the size of horses in England through a combination of regulated breeding and the importation of new bloodlines

Dead or alive?: investigating long-distance transport of live fallow deer and their body parts in antiquity

The extent to which breeding populations of fallow deer were established in Roman Europe has been obscured by the possibility that the skeletal remains of the species, in particular Dama foot bones and antlers, were traded over long distances as objects in their own right. This paper sets out to refine our understanding of the evidence for the transportation of living and dead fallow deer in Iron Age and Roman Europe. To achieve this, museum archives containing purportedly early examples of Dama antler were searched, with available specimens sampled for carbon, nitrogen and strontium isotope analyses, and compared with data for archaeological fallow deer from across Europe. Importantly, the resulting isotope values can be interpreted in light of new modern baseline data for fallow deer presented here. Together these multi-isotope results for modern and archaeological fallow deer provide a more critical perspective on the transportation of fallow deer and their body parts in antiquity

Retention of skills learnt in Alexander technique lessons: 28 people with idiopathic Parkinson's disease

The Alexander technique is a preventive, re-educative, self-help technique for improving the efficiency of overall balance and co-ordination. This paper describes the responses to a questionnaire completed by a sample of 28 people with idiopathic Parkinson's disease six months after receiving a course of lessons as participants in a controlled trial. It is the first time that retention of skills has been investigated in relation to learning the Alexander technique. Twenty-seven people (96%) said that they were continuing to use the Alexander technique in their daily life; most often while walking, sitting or standing. Twenty-four people (86%) were also practising the Alexander technique while lying down in a semi-supine position. Ten people (36%) were using the Alexander technique when they needed more control especially in crowds and social situations and seven (25%) in stressful situations. The responses show that every participant retained some degree of skill; at the same time the responses indicate a wide variation in level of commitment and application

Randomized controlled trial of the Alexander Technique for idiopathic Parkinson's disease

Objective: To determine whether the Alexander Technique, alongside normal treatment, is of benefit to people disabled by idiopathic Parkinson's disease. Design: A randomized controlled trial with three groups, one receiving lessons in the Alexander Technique, another receiving massage and one with no additional intervention. Measures were taken pre and post-intervention, and at follow-up, six months later. Setting: The Polyclinic at the University of Westminster, Central London. Subjects: Ninety-three people with clinically confirmed idiopathic Parkinson's disease. Interventions: The Alexander Technique group received 24 lessons in the Alexander Technique and the massage group received 24 sessions of massage. Main outcome measures: The main outcome measures were the Self-assessment Parkinson's Disease Disability Scale (SPDDS) at best and at worst times of day. Secondary measures included the Beck Depression Inventory and an Attitudes to Self Scale. Results: The Alexander Technique group improved compared with the no additional intervention group, pre-intervention to post-intervention, both on the SPDDS at best, p = 0.04 (confidence interval (CI) -6.4 to 0.0) and on the SPDDS at worst, p = 0.01 (CI -11.5 to -1.8). The comparative improvement was maintained at six-month follow-up: on the SPDDS at best, p = 0.04 (CI -7.7 to 0.0) and on the SPDDS at worst, p = 0.01 (CI -11.8 to -0.9). The Alexander Technique group was comparatively less depressed post-intervention, p = 0.03 (CI -3.8 to 0.0) on the Beck Depression Inventory, and at six-month follow-up had improved on the Attitudes to Self Scale, p = 0.04 (CI -13.9 to 0.0). Conclusions: There is evidence that lessons in the Alexander Technique are likely to lead to sustained benefit for people with Parkinson's disease. Reprinted by permission of Sage Publications Ltd from Stallibrass, Chloe and Sissons, P. and Chalmers, C. (2002), Clinical Rehabilitation, 16 (7). pp. 695-708. Copyright 2002 SAGE Publications (London, Thousand Oaks, CA and New Delhi

Σκιαγραφώντας το “αστικό προφίλ” μιας αρχαίας ελληνικής πόλης: στοιχεία από το ερευνητικό Πρόγραμμα της Ολύνθου

[EN] This article argues that a holistic approach to documenting and understanding the physical evidence for individual cities would enhance our ability to address major questions about urbanisation, urbanism, cultural identities and economic processes. At the same time we suggest that providing more comprehensive data-sets concerning Greek cities would represent an important contribution to cross-cultural studies of urban development and urbanism, which have often overlooked relevant evidence from Classical Greece. As an example of the approach we are advocating, we offer detailed discussion of data from the Archaic and Classical city of Olynthos, in the Halkidiki. Six seasons of fieldwork here by the Olynthos Project, together with legacy data from earlier projects by the American School of Classical Studies at Athens and by the Greek Archaeological Service, combine to make this one of the best-documented urban centres surviving from the Greek world. We suggest that the material from the site offers the potential to build up a detailed ‘urban profile’, consisting of an overview of the early development of the community as well as an in-depth picture of the organisation of the Classical settlement. Some aspects of the urban infrastructure can also be quantified, allowing a new assessment of (for example) its demography. This article offers a sample of the kinds of data available and the sorts of questions that can be addressed in constructing such a profile, based on a brief summary of the interim results of fieldwork and data analysis carried out by the Olynthos Project, with a focus on research undertaken during the 2017, 2018 and 2019 seasons.[EL] Το άρθρο υποστηρίζει ότι μια ολιστική προσέγγιση στην τεκμηρίωση και κατανόηση των υλικών καταλοίπων σε επίπεδο πόλεων θα μας βοηθούσε στην προσπάθειά μας να απαντήσουμε σημαντικά ερωτήματα σχετικά με τη διαδικασία της αστικοποίησης, τον αστικό τρόπο ζωής, τις πολιτισμικές ταυτότητες και τις οικονομικές διεργασίες στον αρχαίο κόσμο. Ταυτόχρονα θεωρούμε ότι η συγκρότηση πιο περιεκτικών συνόλων από δεδομένα που αφορούν αρχαίες ελληνικές πόλεις θα προσέφερε σημαντικά και στη διαπολιτισμική μελέτη της αστικής εξέλιξης και του αστικού τρόπου ζωής, η οποία έχει συχνά αγνοήσει τα σχετικά στοιχεία από την κλασική Ελλάδα. Ως παράδειγμα για την προσέγγιση που προτείνουμε προσφέρουμε μιαν αναλυτική συζήτηση των δεδομένων από την αρχαϊκή και κλασική πόλη της Ολύνθου στη Χαλκιδική. Ο συνδυασμός έξι περιόδων έρευνας πεδίου από το Πρόγραμμα της Ολύνθου και στοιχείων από τα αρχεία παλαιότερων προγραμμάτων της Αμερικανικής Σχολής Κλασικών Σπουδών στην Αθήνα και της Ελληνικής Αρχαιολογικής Υπηρεσίας καθιστά την Όλυνθο ένα από τα καλύτερα τεκμηριωμένα αστικά κέντρα του αρχαίου ελληνικού κόσμου που έχουν διασωθεί. Υποστηρίζουμε ότι το υλικό από τη θέση μάς δίνει τη δυνατότητα να σκιαγραφήσουμε ένα λεπτομερές «αστικό προφίλ», το οποίο αποτελείται από μια επισκόπηση της πρώιμης εξέλιξης της κοινότητας καθώς και μια σε βάθος απεικόνιση της οργάνωσης του οικισμού της κλασικής περιόδου. Η δυνατότητα ποσοτικοποίησης κάποιων παραμέτρων της αστικής υποδομής μάς επιτρέπει να προβούμε σε νέες εκτιμήσεις, για παράδειγμα σχετικά με τη δημογραφία. Το άρθρο προσφέρει ένα δείγμα του τύπου των διαθέσιμων δεδομένων και του είδους των ερωτημάτων που μπορεί να τεθούν στη σκιαγράφηση ενός τέτοιου προφίλ, βασισμένο σε μια περίληψη των προσωρινών αποτελεσμάτων από τις εργασίες πεδίου και τις αναλύσεις των δεδομένων που διενήργησε το Πρόγραμμα της Ολύνθου και με έμφαση στην έρευνα που διεξήχθη κατά το 2017, το 2018 και το 2019.Peer reviewe

Developmental palaeontology in synapsids: the fossil record of ontogeny in mammals and their closest relatives

The study of fossilized ontogenies in mammals is mostly restricted to postnatal and late stages of growth, but nevertheless can deliver great insights into life history and evolutionary mechanisms affecting all aspects of development. Fossils provide evidence of developmental plasticity determined by ecological factors, as when allometric relations are modified in species which invaded a new space with a very different selection regime. This is the case of dwarfing and gigantism evolution in islands. Skeletochronological studies are restricted to the examination of growth marks mostly in the cement and dentine of teeth and can provide absolute age estimates. These, together with dental replacement data considered in a phylogenetic context, provide life-history information such as maturation time and longevity. Palaeohistology and dental replacement data document the more or less gradual but also convergent evolution of mammalian growth features during early synapsid evolution. Adult phenotypes of extinct mammals can inform developmental processes by showing a combination of features or levels of integration unrecorded in living species. Some adult features such as vertebral number, easily recorded in fossils, provide indirect information about somitogenesis and hox-gene expression boundaries. Developmental palaeontology is relevant for the discourse of ecological developmental biology, an area of research where features of growth and variation are fundamental and accessible among fossil mammals