Measuring and managing foot muscle weakness

Foot muscle weakness is caused by disease, injury, inactivity and ageing, with disabling consequences. Exercise improves muscle weakness however, adherence to correct technique is challenging. Biofeedback may improve performance. Chapter One reviews the literature on small foot muscles, muscle function, measurement, causes and consequences of foot muscle weakness, and the role of exercise. Chapter Two is a systematic review on the relationship between foot pain, muscle strength and size. Eight studies were identified evaluating the relationship between foot pain and foot muscle strength or size, with a significant association between foot pain and muscle weakness when pain is of high intensity and weakness measured by toe flexion force. Chapter Three is a reliability study assessing size of abductor hallucis and medial belly flexor hallucis brevis muscles by ultrasound in 21 adults and identify their relationship with toe strength, foot morphology, balance. Intra-rater reliability was excellent. Significant associations were found between cross-sectional area of abductor hallucis with great toe flexion force, arch height sit and stand, truncated and full foot length, balance. Significant associations found between cross-sectional area of medial belly flexor hallucis brevis with Foot Posture Index, truncated and full foot length. After controlling for body size, cross-sectional area of abductor hallucis remained a significant correlate of great toe flexor strength. Chapter Four describes the development of the Archie biofeedback device. Device feasibility is evaluated in Chapter Five by repeat testing of 30 adults performing four foot exercises using Archie, with 89% of exercise and foot location variables collected consistently. Biofeedback significantly improved foot location for all exercises and 97% of participants reported biofeedback helped exercise performance. Archie appears to be a safe and feasible biofeedback device to assist participants perform exercise

R v Hall and the changing perceptions of the crime of bigamy

This is the author accepted manuscript. The final version is available from Cambridge University Press via the DOI in this record.In 1845, the conviction of Thomas Hall for bigamy was reported as an example of the unequal way in which the law operated, with great play being made of the steps that Hall could have taken to free himself from his first wife by a divorce, were it not for the cost involved. Since then, virtually every account of nineteenth-century bigamy or divorce has included some version of the judge's apparently ‘brilliantly sarcastic’ speech. But what the judge was reported as saying at the time differs in a number of crucial particulars from what later commentators have reported him as saying. Later accounts have played up the misconduct of the first wife, inflated the cost of obtaining a divorce, and exaggerated the poverty and lowly status of Hall, while playing down the sentence he received and ignoring his deception of his second wife. This paper traces the evolution of the account over time, and identifies the timing of the various changes that were made. It illustrates how history is used – by politicians, reformers, and scholars – to support both a particular view of the past and to bolster claims as to how the law should change for the future

A Systematic Review of the Effects of Pilates Method of Exercise in Healthy People

Objective: To evaluate evidence for the effectiveness of the Pilates method of exercise (PME) in healthy people. Data Sources: Published research was identified by searching Science Direct, MEDLINE, PubMed, SPORTDiscus, PEDro, Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. Study Selection: Research studies published from inception to May 7, 2011 were selected for evaluation. Two reviewers independently applied the inclusion criteria to selected potential studies. Studies were included if they were published in a peer-reviewed journal, written in the English language, conducted as a randomized controlled trial (RCT) or quasi-RCT in healthy people, had an inactive and/or exercise control group(s), included key study outcomes, and used the PME as the study intervention in at least 1 study arm. Data Extraction: Two reviewers independently extracted data (study, design, subjects, intervention, key outcomes results), applied the Physiotherapy Evidence Database (PEDro) scale to assess the method quality of selected studies, and determined the strength of the evidence using the best evidence synthesis grading system. Data Synthesis: Sixteen studies met the inclusion criteria. PEDro scale values ranged from 3 to 7 (mean, 4.1), indicating a low level of scientific rigor. The outcomes studied most often were flexibility, muscular endurance, strength, and postural alignment. The PME appears to be effective in improving flexibility (strong evidence), dynamic balance (strong evidence), and muscular endurance (moderate evidence) in healthy people. Conclusions: There was strong evidence to support the use of the PME at least to the end of training to improve flexibility and dynamic balance and moderate evidence to enhance muscular endurance. Future RCTs should focus on the components of blinding, concealed allocation, subject adherence, intention- to-treat analysis, and follow-up designs