Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series

BACKGROUND: The combination of spinal manipulation and various physiotherapeutic procedures used to correct the curvatures associated with scoliosis have been largely unsuccessful. Typically, the goals of these procedures are often to relax, strengthen, or stretch musculotendinous and/or ligamentous structures. In this study, we investigate the possible benefits of combining spinal manipulation, positional traction, and neuromuscular reeducation in the treatment of idiopathic scoliosis. METHODS: A total of 22 patient files were selected to participate in the protocol. Of these, 19 met the study criterion required for analysis of treatment benefits. Anteroposterior radiographs were taken of each subject prior to treatment intervention and 4–6 weeks following the intervention. A Cobb angle was drawn and analyzed on each radiograph, so pre and post comparisons could be made. RESULTS: After 4–6 weeks of treatment, the treatment group averaged a 17° reduction in their Cobb angle measurements. None of the patients' Cobb angles increased. A total of 3 subjects were dismissed from the study for noncompliance relating to home care instructions, leaving 19 subjects to be evaluated post-intervention. CONCLUSIONS: The combined use of spinal manipulation and postural therapy appeared to significantly reduce the severity of the Cobb angle in all 19 subjects. These results warrant further testing of this protocol

Global Intermittency and Collapsing Turbulence in the Stratified Planetary Boundary Layer

Direct numerical simulation of the turbulent Ekman layer over a smooth wall is used to investigate bulk properties of a planetary boundary layer under stable stratification. Our simplified configuration depends on two non-dimensional parameters: a Richardson number characterizing the stratification and a Reynolds number characterizing the turbulence scale separation. This simplified configuration is sufficient to reproduce global intermittency, a turbulence collapse, and the decoupling of the surface from the outer region of the boundary layer. Global intermittency appears even in the absence of local perturbations at the surface; the only requirement is that large-scale structures several times wider than the boundary-layer height have enough space to develop. Analysis of the mean velocity, turbulence kinetic energy, and external intermittency is used to investigate the large-scale structures and corresponding differences between stably stratified Ekman flow and channel flow. Both configurations show a similar transition to the turbulence collapse, overshoot of turbulence kinetic energy, and spectral properties. Differences in the outer region resulting from the rotation of the system lead, however, to the generation of enstrophy in the non-turbulent patches of the Ekman flow. The coefficient of the stability correction function from Monin-Obukhov similarity theory is estimated as (Formula presented.) in agreement with atmospheric observations, theoretical considerations, and results from stably stratified channel flows. Our results demonstrate the applicability of this set-up to atmospheric problems despite the intermediate Reynolds number achieved in our simulations. © 2014 The Author(s)

Modelling atmospheric structure, cloud and their response to CCN in the central Arctic : ASCOS case studies

Observations made during late summer in the central Arctic Ocean, as part of the Arctic Summer Cloud Ocean Study (ASCOS), are used to evaluate cloud and vertical temperature structure in the Met Office Unified Model (MetUM). The observation period can be split into 5 regimes; the first two regimes had a large number of frontal systems, which were associated with deep cloud. During the remainder of the campaign a layer of low-level cloud occurred, typical of central Arctic summer conditions, along with two periods of greatly reduced cloud cover. The short-range operational NWP forecasts could not accurately reproduce the observed variations in near-surface temperature. A major source of this error was found to be the temperature-dependant surface albedo parameterisation scheme. The model reproduced the low-level cloud layer, though it was too thin, too shallow, and in a boundary-layer that was too frequently well-mixed. The model was also unable to reproduce the observed periods of reduced cloud cover, which were associated with very low cloud condensation nuclei (CCN) concentrations (< 1 cm(-3)). As with most global NWP models, the MetUM does not have a prognostic aerosol/cloud scheme but uses a constant CCN concentration of 100 cm(-3) over all marine environments. It is therefore unable to represent the low CCN number concentrations and the rapid variations in concentration frequently observed in the central Arctic during late summer. Experiments with a single-column model configuration of the MetUM show that reducing model CCN number concentrations to observed values reduces the amount of cloud, increases the near-surface stability, and improves the representation of both the surface radiation fluxes and the surface temperature. The model is shown to be sensitive to CCN only when number concentrations are less than 10-20 cm(-3)

Learning from laboratory-induced falling: long-term motor retention among older adults

Falls in older adults are a major health and societal problem. It is thus imperative to develop highly effective training paradigms to reduce the likelihood of falls. Perturbation training is one such emerging paradigm known to induce shorter term fall reduction in healthy young as well as older adults. Its longer term benefits are not fully understood, however. The purpose of this study was to determine whether and to what degree older adults could retain their fall-resisting skills acquired from a single perturbation training session. Seventy-three community-dwelling older adults (≥65 years) received identical single-session perturbation training consisting of 24 slips. This was delivered through unannounced unlocking (and mixed with relocking) of low-friction movable sections of the walkway. A single retest was subsequently scheduled based on a three-stage sequential, pre-post-retest design. Outcome measurements, taken upon the first (novel) and the 24th (final) slips of the initial session and the retest slip, included fall-or-no-fall and stability (quantified by the shortest distance from relative motion state of the center-of-mass and the base-of-support to the limits of stability) at instants prior to (proactive) and after (reactive) the onset of the slip. The training boosted subjects’ resilience against laboratory-induced falls demonstrated by a significant reduction from 42.5 % falls on the first slip to 0 % on the 24th slip. Rate of falls which occurred during the laboratory retest remained low in 6-month (0 %), 9-month (8.7 %), and 12-month retest (11.5 %), with no significant difference between the three time intervals. Such reduction of laboratory-induced falls and its retention were attributable to the significant training-induced improvement in the proactive and reactive control of stability. This unique pre-post-retest design enabled us to provide scientific basis for the feasibility of a single session of perturbation training to “inoculate” older adults and to reduce their annual risk of falls in everyday living