Walking in multiple sclerosis improves with tDCS: a randomized, double‐blind, sham‐controlled study

Objective: To evaluate whether multiple sessions of transcranial direct current stimulation (tDCS) applied to the primary motor (M1) cortex paired with aer- obic exercise can improve walking functions in multiple sclerosis (MS). Meth- ods: MS participants were recruited for a double-blind, parallel-arm, randomized, sham-controlled trial and assigned to 10 sessions (5 d/wk for 2 weeks) of either active or sham tDCS paired with unloaded cycling for 20 minutes. Stimulation was administered over the left M1 cortex (2.5 mA; anode over C3/cathode over FP2). Gait spatiotemporal parameters were assessed using a wearable inertial sensor (10-meter and 2-minute walking tests). Mea- surements were collected at baseline, end of tDCS intervention, and 4-week postintervention to test for duration of any benefits. Results: A total of 15 par- ticipants completed the study, nine in the active and six in the sham condition. The active and sham groups were matched according to gender (50% vs. 40% female), neurologic disability (median EDSS 5.5 vs. 5), and age (mean 52.1 ! 12.9 vs. 53.7 ! 9.8 years). The active group had a significantly greater increase in gait speed (0.87 vs. 1.20 m/s, p < 0.001) and distance covered dur- ing the 2-minute walking test (118.53 vs. 133.06 m, p < 0.001) at intervention end compared to baseline. At 4-week follow-up, these improvements were maintained (baseline vs. follow-up: gait speed 0.87 vs. 1.18 m/s, p < 0.001; dis- tance traveled 118.53 vs. 143.82 m, p < 0.001). Interpretation: Multiple ses- sions of tDCS paired with aerobic exercise lead to cumulative and persisting mprovements in walking and endurance in patients with MS

Global Drivers on Southern Ocean Ecosystems: Changing Physical Environments and Anthropogenic Pressures in an Earth System

Copyright © 2020 Morley, Abele, Barnes, Cárdenas, Cotté, Gutt, Henley, Höfer, Hughes, Martin, Moffat, Raphael, Stammerjohn, Suckling, Tulloch, Waller and Constable. The manuscript assesses the current and expected future global drivers of Southern Ocean (SO) ecosystems. Atmospheric ozone depletion over the Antarctic since the 1970s, has been a key driver, resulting in springtime cooling of the stratosphere and intensification of the polar vortex, increasing the frequency of positive phases of the Southern Annular Mode (SAM). This increases warm air-flow over the East Pacific sector (Western Antarctic Peninsula) and cold air flow over the West Pacific sector. SAM as well as El Niño Southern Oscillation events also affect the Amundsen Sea Low leading to either positive or negative sea ice anomalies in the west and east Pacific sectors, respectively. The strengthening of westerly winds is also linked to shoaling of deep warmer water onto the continental shelves, particularly in the East Pacific and Atlantic sectors. Air and ocean warming has led to changes in the cryosphere, with glacial and ice sheet melting in both sectors, opening up new ice free areas to biological productivity, but increasing seafloor disturbance by icebergs. The increased melting is correlated with a salinity decrease particularly in the surface 100 m. Such processes could increase the availability of iron, which is currently limiting primary production over much of the SO. Increasing CO2 is one of the most important SO anthropogenic drivers and is likely to affect marine ecosystems in the coming decades. While levels of many pollutants are lower than elsewhere, persistent organic pollutants (POPs) and plastics have been detected in the SO, with concentrations likely enhanced by migratory species. With increased marine traffic and weakening of ocean barriers the risk of the establishment of non-indigenous species is increased. The continued recovery of the ozone hole creates uncertainty over the reversal in sea ice trends, especially in the light of the abrupt transition from record high to record low Antarctic sea ice extent since spring 2016. The current rate of change in physical and anthropogenic drivers is certain to impact the Marine Ecosystem Assessment of the Southern Ocean (MEASO) region in the near future and will have a wide range of impacts across the marine ecosystem

The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

The FLUXNET2015 dataset provides ecosystem-scale data on CO2, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible.Peer reviewe

Effects of Cooling on Ground Reaction Forces, Knee Kinematics, and Jump Height in Drop Jumps

This study investigated the effect of knee joint ice application on vertical ground reaction forces (VGRF), knee angle (KA), and jump height (JH) during a single-leg drop jump in 20 healthy participants randomly assigned to an experimental or control group. VGRF were measured using a force plate, KA was measured using an electrogoniometer, and JH was derived from VGRF. After the pretests, a crushed-ice bag was applied to the experimental group participants for 20 minutes, whereas the control group rested. All participants were retested immediately and again after 20 minutes of rest. Significant decreases in average braking phase VGRF (–0.18±0.14 body weight) and increases in contact time (51±39 ms) were found after icing. In addition, several nonsignificant trends toward force reduction were identified. These findings support the statement that when athletes return to competition after icing, an altered neuromuscular behavior might lead to potential re-injury situations

Effect of knee joint cooling on the electromyographic activity of lower extremity muscles during a plyometric exercise

During sporting events, injured athletes often return to competition after icing because of the reduction in pain. Although some controversy exists, several studies suggest that cryotherapy causes a decrease in muscle activity, which may lead to a higher risk of injury upon return to play. The purpose of this study was to investigate the effect of a 20-min knee joint cryotherapy application on the electromyographic activity of leg muscles during a single-leg drop jump in twenty healthy subjects, randomly assigned to an experimental and a control group. After the pre-tests, a crushed-ice bag was applied to the knee joint of the experimental group subjects for 20 min, while the control group subjects rested for 20 min. All subjects were retested immediately after this period and retested again after another 20 min of rest. Average electromyographic activity and ground contact time were calculated for the pre- and post-test sessions. Decreases in electromyographic activity of the lower extremity musculature were found in pre-activation, eccentric (braking), and concentric (push-off) phases immediately after the icing, and after 20 min of rest. The results lend support to the suggestion that cryotherapy during sporting events may place the individuals in a vulnerable position

Health Competency Standards in Physical Therapist Practice

Although the physical therapist profession is the leading established, largely nonpharmacological health profession in the world and is committed to health promotion and noncommunicable disease (NCD) prevention, these have yet to be designated as core physical therapist competencies. Based on findings of 3 Physical Therapy Summits on Global Health, addressing NCDs (heart disease, cancer, hypertension, stroke, diabetes, obesity, and chronic lung disease) has been declared an urgent professional priority. The Third Summit established the status of health competencies in physical therapist practice across the 5 World Confederation for Physical Therapy (WCPT) regions with a view to establish health competency standards, this article's focus. Three general principles related to health-focused practice emerged, along with 3 recommendations for its inclusion. Participants acknowledged that specific competencies are needed to ensure that health promotion and NCD prevention are practiced consistently by physical therapists within and across WCPT regions (ie, effective counseling for smoking cessation, basic nutrition, weight control, and reduced sitting and increased activity/exercise in patients and clients, irrespective of their presenting complaints/diagnoses). Minimum accreditable health competency standards within the profession, including use of the WCPT-supported Health Improvement Card, were recommended for inclusion into practice, entry-to-practice education, and research. Such standards are highly consistent with the mission of the WCPT and the World Health Organization. The physical therapist profession needs to assume a leadership role vis-à-vis eliminating the gap between what we know unequivocally about the causes of and contributors to NCDs and the long-term benefits of effective, sustained, nonpharmacological lifestyle behavior change, which no drug nor many surgical procedures have been reported to match. © 2019 American Physical Therapy Association