Acute rotator cuff tendinopathy: does ice, low load isometric exercise, or a combination of the two produce an analgaesic effect?

This document is the Accepted Manuscript version of the following article: Parle PJ, Riddiford-Harland DL, Howitt CD, et al. 'Acute rotator cuff tendinopathy: does ice, low load isometric exercise, or a combination of the two produce an analgaesic effect?.' Br J Sports Med 2017;51:208-209, doi: http://dx.doi.org/10.1136/bjsports-2016-096107.Rotator cuff tendinopathies are the most commonly diagnosed musculoskeletal shoulder conditions and are associated with pain, weakness and loss of function.1 Tendon swelling may be associated with tendinopathy and may result from acute overload.2–3 An increase in tendon cells (tenocytes) and upregulation of large molecular weight proteoglycans, such as aggrecan, may increase tendon water content.2 There is uncertainty as to whether the swelling is related to the pain or is instead an observed but unrelated phenomenon. Weakness detected clinically may be due to pain inhibition.4–5 Early treatment of acute rotator cuff tendinopathy involves patient education and relative rest, and may include non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain, swelling and inflammation. Subacromial corticosteroid injections are also used to achieve the same purpose. These techniques show low to moderate evidence of reducing short-term pain but they do not improve function.6 The medications have side effects such as gastrointestinal tract complaints,7 and corticosteroids may damage tendon tissue.8 Identifying alternative ways to control pain and inflammation may be warranted. Two clinical procedures to manage RC tendinopathy include ice wraps and isometric exercise, however, there are no empirical data supporting their use. This pilot study, conducted at the Illawarra Sports Medicine Clinic, NSW, Australia, was designed to test (1) the short term analgaesic effect of these interventions and (2) the feasibility of a larger clinical trial for adults diagnosed with acute rotator cuff tendinopathy (<12 weeks).Peer reviewe

Intranasal Inhalation of Oxytocin Improves Face Processing in Developmental Prosopagnosia

Developmental prosopagnosia (DP) is characterised by a severe, lifelong impairment in face recognition. Little work has attempted to improve face processing in these individuals, but intriguingly, recent evidence suggests oxytocin can improve face processing in both healthy participants and individuals with autism. This study examined whether oxytocin could also improve face processing in individuals with DP. Ten adults with the condition and 10 matched controls were tested using a randomized placebo-controlled double-blind within-subject experimental design (AB-BA). Each participant took part in two testing sessions where they inhaled 24IU of oxytocin or placebo spray and completed two face processing tests: one assessing face memory and the other face perception. Results showed main effects of both participant group and treatment condition in both face processing tests, but the two did not interact. Specifically, the performance of DP participants was significantly lower than control performance under both oxytocin and placebo conditions, but oxytocin improved processing to a similar extent in both groups

Algorithms for Robot Coverage Under Movement and Sensing Constraints

This thesis explores the problem of generating coverage paths—that is, paths that pass within some sensor footprint of every point in an environment—for mobile robots. It both considers models for which navigation is a solved problem but motions are constrained, as well for models in which navigation must be considered along with coverage planning because of the robot’s unreliable sensing and movements. The motion constraint we adopt for the former is a common constraint, that of a Dubins vehicle. We extend previous work that solves this coverage problem as a traveling salesman problem (TSP) by introducing a practical heuristic algorithm to reduce runtime while maintaining near-optimal path length. Furthermore, we show that generating an optimal coverage path is NP-hard by reducing from the Exact Cover problem, which provides justification for our algorithm’s conversion of Dubins coverage instances to TSP instances. Extensive experiments demonstrate that the algorithm does indeed produce path lengths comparable to optimal in significantly less time. In the second model, we consider the problem of coverage planning for a particular type of very simple mobile robot. The robot must be able to translate in a commanded direction (specified in a global reference frame), with bounded error on the motion direction, until reaching the environment boundary. The objective, for a given environment map, is to generate a sequence of motions that is guaranteed to cover as large a portion of that environment as possible, in spite of the severe limits on the robot’s sensing and actuation abilities. We show how to model the knowledge available to this kind of robot about its own position within the environment, show how to compute the region whose coverage can be guaranteed for a given plan, and characterize regions whose coverage cannot be guaranteed by any plan. We also describe an algorithm that generates coverage plans for this robot, based on a search across a specially-constructed graph. Simulation results demonstrate the effectiveness of the approach

Supramolecular aggregation in dithia-arsoles: chlorides, cations and N-centred paddlewheels

The benzo-fused dithia-chloro-arsole derivative C6H4S2AsCl (1) is found to crystallise in the triclinic space group P[1 with combining macron] with 17 molecules in the asymmetric unit whereas the tolyl derivative, MeC6H3S2AsCl (2) is polymorphic with the α-phase crystallising in the monoclinic space group P21/c with a single molecule in the asymmetric unit and the β-phase adopting a triclinic structure with two molecules in the asymmetric unit. Reaction of these dithia-chloro-arsole derivatives with LiN(SiMe3)2 in a 3 : 1 mole ratio afforded the unique paddlewheel structure (MeC6H4S2As)3N (4)

Properties of Active Galaxies Deduced from H I Observations

We completed a new survey for H I emission for a large, well-defined sample of 154 nearby (z < 0.1) galaxies with type 1 AGNs. We make use of the extensive database presented in a companion paper to perform a comprehensive appraisal of the cold gas content in active galaxies and to seek new strategies to investigate the global properties of the host galaxies and their relationship to their central black holes (BHs). We show that the BH mass obeys a strong, roughly linear relation with the host galaxy's dynamical mass. BH mass follows a looser, though still highly significant, correlation with the maximum rotation velocity of the galaxy, as expected from the known scaling between rotation velocity and central velocity dispersion. Neither of these H I-based correlations is as tight as the more familiar relations between BH mass and bulge luminosity or velocity dispersion, but they offer the advantage of being insensitive to the glare of the nucleus and therefore are promising new tools for probing the host galaxies of both nearby and distant AGNs. We present evidence for substantial ongoing BH growth in the most actively accreting AGNs. In these nearby systems, BH growth appears to be delayed with respect to the assembly of the host galaxy but otherwise has left no detectable perturbation to its mass-to-light ratio or its global gas content. The host galaxies of type 1 AGNs, including those luminous enough to qualify as quasars, are generally gas-rich systems, possessing a cold interstellar medium reservoir at least as abundant as that in inactive galaxies of the same morphological type. This calls into question current implementations of AGN feedback in models of galaxy formation that predict strong cold gas depletion in unobscured AGNs. (Abridged)Comment: To appear in ApJ; 14 page

The Elephant in the Room: Too Much Medicine in Musculoskeletal Practice

Too much medicine burdens health care systems and deprives societies of resources. Overcoming too much medicine requires stakeholders (patients, clinicians, educators, health care funders, media, policy makers, industry, insurers, politicians, etc) to appropriately prioritize low-risk, cost-effective care over higher-risk and more expensive care of equal clinical effectiveness. Professional bodies, government agencies, clinicians, and patients must collaborate to discuss and synthesize the available evidence, share decisions, and translate knowledge. We do not underestimate the challenge of the task. Reducing the harm of medicalizing normality and avoiding the temptation to provide too much medicine in current musculoskeletal practice depend on all of us. © 2020 Journal of Orthopaedic & Sports Physical Therapy

Role of the kinetic chain in shoulder rehabilitation: Does incorporating the trunk and lower limb into shoulder exercise regimes influence shoulder muscle recruitment patterns? Systematic review of electromyography studies

Objective To investigate the influence of trunk and lower limb motion on electromyography (EMG) muscle activity and recruitment patterns around the shoulder. Design Systematic review. Data sources MEDLINE, CINAHL, PEDro, AMED, PubMed, Cochrane Central Register of Controlled trials, Cochrane Database of Systematic reviews, SportsDiscuss and PROSPERO. Eligibility criteria Studies investigating both multiregional kinetic chain (KC) shoulder exercises and localised non-kinetic chain (nKC) shoulder exercises in healthy subjects under the same experimental conditions were included in this review. Results KC exercises produced greater EMG activation levels in 5 of 11 studies for the lower trapezius. Of the remaining studies, five found no difference between the exercise types and one favoured nKC exercises. KC exercises produced greater EMG activation levels in 5 of 11 studies for the serratus anterior. Of the remaining studies, three reported the opposite and three found no significant difference between the exercise types. nKC exercises produced greater EMG activation in infraspinatus in three of four studies. KC exercises produced the lowest trapezius muscle ratios in all studies. Studies investigating the upper trapezius, middle trapezius, supraspinatus, subscapularis, biceps brachii, latifissimus dorsi, pectoralis major, deltoid, and trapezius and serratus anterior ratios showed inconsistency. Conclusion This review found evidence that integrating the KC during shoulder rehabilitation may increase axioscapular muscle recruitment, produce lower trapezius muscle ratios and reduce the demands on the rotator cuff. Stepping appears preferable to squatting. PROSPERO registration number CRD42015032557, 2015. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ