The Elbow-EpiTrainer : A method of delivering graded resistance to the extensor carpi radialis brevis. Effectiveness of a prototype device in a healthy population

This document is the Accepted Manuscript version of the following article: Navsaria R, Ryder DM, Lewis JS, et al, 'The Elbow-EpiTrainer: a method of delivering graded resistance to the extensor carpi radialis brevi:. Effectiveness of a prototype device in a healthy population', British Journal of Sports Medicine, Vol. 49(5):318-322, March 2015, available online at: http://bjsm.bmj.com/content/49/5/318. Published by the BMJ Publishing Group Limited.Background: Tennis elbow or lateral epicondylopathy (LE) is experienced as the lateral elbow has a reported prevalence of 1.3%, with symptoms lasting up to 18 months. LE is most commonly attributed to tendinopathy involving the extensor carpi radialis brevis (ECRB) tendon. The aim of tendinopathy management is to alleviate symptoms and restore function that initially involves relative rest followed by progressive therapeutic exercise. Objective: To assess the effectiveness of two prototype exercises using commonly available clinical equipment to progressively increase resistance and activity of the ECRB. Method: Eighteen healthy participants undertook two exercise progressions. Surface electromyography was used to record ECRB activity during the two progressions, involving eccentric exercises of the wrist extensors and elbow pronation exercises using a prototype device. The two progressions were assessed for their linearity of progression using repeated ANOVA and linear regression analysis. Five participants repeated the study to assess reliability. Results: The exercise progressions led to an increase in ECRB electromyographic (EMG) activity (p0.7) between the first and second tests for five participants. Conclusions: Manipulation of resistance and leverage with the prototype exercises was effective in creating significant increases of ECRB normalised EMG activity in a linear manner that may, with future research, become useful to clinicians treating LE. In addition, between trial reliability for the device to generate a consistent load was acceptable.Peer reviewe

Diversification rates are consistent with diversity patterns across mammalian orders.

<p>(Left panels) Mammalian orders (the eight most species-rich orders—covering 92% of all mammals—are represented, ranked from most to least diverse), their total species richness, and their global latitudinal diversity gradient. (Right panels) Posterior distributions of temperate (in blue) and tropical (in green) speciation, extinction, and net diversification rates estimates, computed using the best-fitting model. The grey color indicates that the best-fitting model had equal rates in the tropical and temperate biomes. The net diversification rate follows a trend consistent with the latitudinal diversity gradient: the net diversification rate is higher in the tropics, except in Lagomorpha, which shows an inverse diversity gradient, and in Carnivora, where the difference in net diversification is not significant. Speciation rate refers to within-biome speciation; speciation by biome divergence, which contributes to species richness in the tropical and temperate regions equally, is not included in this figure.</p

Support for the “out of the tropics” scenario of mammalian species richness.

<p>From left to right, global latitudinal diversity gradient of all mammals, and posterior distributions of speciation, extinction, net diversification, and dispersal rates corresponding to the temperate (in blue) and tropical biomes (in green). Faster speciation and reduced extinction in the tropics result in a higher net diversification rate. Range expansion from the tropics to the temperate regions is more frequent than the other way around. Posterior distributions were computed using MCMC analyses for the best-fitting model on the consensus tree. Bars below each distribution correspond to the shaded area and represent the 95% credibility interval of each estimated parameter. Speciation rate refers to within-biome speciation; speciation by biome divergence, which contributes to species richness in the tropical and temperate regions equally, is not included in this figure.</p

Speciation and extinction rates through time in the temperate and tropical biomes.

<p>The speciation rate is higher, and the extinction rate lower, in the tropical biome over the majority of clade history. Lines represent the posterior mean estimates and shaded areas 95% credibility intervals.</p

Molecular dataset and phylogeny of Cycadales

This ZIP file contains two files. First, the molecular dataset (three genes, 5587 nucleotides, and 243 taxa) used to build the phylogeny, and to estimate origin and divergence times of the Cycadales. This is a NEXUS format, ready for MrBayes analyses. Second, the MrBayes tree obtained from the analysis described in the paper

Appendix 8 - Bayesian paleoenvironmental model

Description of the Bayesian episodic environment-dependent birth-death model

Scripts and R codes for diversification analyses

Scripts and R codes for diversification analyse

Appendix 3 - Parnassiinae_Fossils_MB

The total-evidence matrix (including molecular and morphological data) used for the phylogenetic placement of fossils with MrBayes

Appendix 6 - Adjacency matrices through time

The time-stratified biogeographic model used for DEC analyses (time slices represent geological epochs or stages in the Cenozoic)

Appendix 2 - Gene alignments and trees

The individual gene alignments as recovered by MAFFT. Results of the Bayesian phylogenetic analyses for each gene, and an explanation of the results