Abstract Background Context Spinal manipulative therapy (SMT) has been attributed with substantial non-specific effects. Accurate assessment of the non-specific effects of SMT relies on high-quality ...studies with low risk of bias that compare to appropriate placebos. Purpose This review aims to characterize the types and qualities of placebo control procedures used in controlled trials of manually-applied, lumbar and pelvic (LP) SMT, and to evaluate the assessment of subject blinding and expectations. Study Design This is a systematic review of randomized, placebo-controlled trials. Methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature and relevant bibliographies. We included randomized, placebo/sham-controlled trials where the index treatment was manually applied LP-SMT. There were no restrictions on the type of condition being investigated. Two independent reviewers selected the studies, assessed study quality and extracted the data. Relevant data were the type and quality of placebo control(s) used, the assessment of blinding and expectations and the results of those assessments. Results Twenty-five randomized, placebo-controlled trials were included in this review. There were 18 trials that used a sham manual SMT procedure for their placebo control intervention; the most common approach was with an SMT set-up, but without the application of any thrust. One small pilot study used an unequivocally indistinguishable placebo, 2 trials used placebos that had been validated as inert a priori , and 8 trials reported on success of subject blinding. Risk of bias was high or unclear, for all included studies. Conclusions Imperfect placebos are ubiquitous in clinical trials of LP-SMT and few trials have assessed for successful subject blinding or balanced expectations of treatment success between active and control group subjects. There is thus a strong potential for unmasking of control subjects, unequal non-specific effects between active and control groups, and non-inert placebos in existing trials. Future trials should consider assessing the success of subject blinding and ensuring inertness of their placebo a priori, as a minimum standard for quality.
Comparisons of target-based reaching vs memory-based (pantomime) reaching have been used to obtain insight into the visuomotor control of reaching. The present study examined the contribution of gaze ...anchoring, reaching to a target that is under continuous gaze, to both target-based and memory-based reaching. Participants made target-based reaches for discs located on a table or food items located on a pedestal or they replaced the objects. They then made memory-based reaches in which they pantomimed their target-based reaches. Participants were fitted with hand sensors for kinematic tracking and an eye tracker to monitor gaze. When making target-based reaches, participants directed gaze to the target location from reach onset to offset without interrupting saccades. Similar gaze anchoring was present for memory-based reaches when the surface upon which the target had been placed remained. When the target and its surface were both removed there was no systematic relationship between gaze and the reach. Gaze anchoring was also present when participants replaced a target on a surface, a movement featuring a reach but little grasp. That memory-based reaches can be either gaze anchor-associated or gaze anchor-independent is discussed in relation to contemporary views of the neural control of reaching.
Tool-use has been found to change body representation. For example, participants who briefly used a mechanical grabber to pick up objects perceived their forearms to be longer immediately after its ...use (e.g., Cardinali et al., Curr Biol 19(12):R478–R479, 2009; they incorporated the tool into their perceived arm size). While some studies have investigated the long-term effects of tool-use on body representation, none of these studies have used a tool that encapsulates the entire body part (e.g., a glove). Moreover, the relationship between tool-use and the body model (the representation of the body’s spatial characteristics) has yet to be explored. To test this, we recruited 19 elite baseball players (EBP) and 18 age-matched controls to participate in a hand representation task. We included EBP because of their many years (8+) of training with a tool (baseball glove). The task required participants to place their hands underneath a covered glass tabletop (no vision of their hands), and to point to where they believed 10 locations (the tips and bases of each finger) were on their hands (Coelho et al., Psychol Res 81(6):1224–1231, 2017). Each point’s XY coordinates was tracked using an Optotrak camera. From these coordinates, we mapped out the participants perceived hand size. The results showed that when compared to the controls, EBP underestimated hand width and finger length of both hands. This indicates that long-term tool use produces changes in the body model for both, the trained and untrained hands. We conducted a follow-up study to examine if 15 min of glove use would change perceived hand size in control participants. Novice baseball players (participants without baseball experience: NBP) were recruited and hand maps were derived before and after 15 min of active catching with a glove. Results showed no significant differences between the pre and post hand maps. When we compared between the two experiments, the EBP showed smaller hand representation for both hand width and finger length, than the NBP. We discuss these results in relation to theories of altered body ownership.
There is a movement preparation cost for bimanual asymmetric reaching movements compared to bimanual symmetric movements. This is likely caused by the complex spatiotemporal coupling of bimanual ...asymmetric movements. The spatiotemporal coupling of bimanual reach-to-grasp movements has been investigated, but not the potential movement preparation costs. The purpose of the present study was to investigate the relationship between movement preparation costs and spatiotemporal coupling of reach-to-grasp movements. Twenty-four participants made unimanual, bimanual symmetric, and bimanual asymmetric reach-to-grasp movements in four-choice reaction time tasks. There was a movement preparation cost for bimanual symmetric reach-to-grasp movements compared to unimanual movements, which was not previously seen for reaching movements. Coordinating two symmetric grasps probably caused this bimanual symmetric cost, as we have previously shown that there is no bimanual symmetric cost for reaching movements. It was also surprising that the complexity of movement preparation was comparable for bimanual symmetric and asymmetric reach-to-grasp movements. However, the spatial coupling of bimanual asymmetric movements at movement initiation suggested that they were prepared as bimanual symmetric movements. Online control was then used to modify these symmetric reach-to-grasp movements into asymmetric movements. Preparing bimanual symmetric reach-to-grasp movements in advance instead of asymmetric movements likely prevented a bimanual asymmetric cost.
Background
Exercise interventions are often less effective at improving body composition for females than males, potentially due to post-exercise hormonal responses that increase energy intake in ...females. Recently, sprint interval training was shown to effectively reduce body fat in females despite being relatively low during exercise energy expenditure.
Purpose
To determine whether any sex difference in total PYY, GLP-1 or perceived hunger exists following moderate-intensity continuous exercise (MICT) and sprint interval exercise (SIT)
Methods
Twenty-one active participants (11 females) participated in three sessions in a randomized crossover design: (1) MICT, 30-min cycling at 65% VO
2max
; (2) SIT, 6 × 30 s “all-out” sprints with 4-min recovery periods; (3) control (CTRL; no exercise). Blood samples were collected pre-exercise, immediately and 90 min post-exercise for the measurement of total PYY and GLP-1. Subjective perceptions of hunger were assessed using a visual analogue scale pre-breakfast and before all blood samples.
Results
Concentrations of total PYY and GLP-1 were greater during MICT (
P
= 0.05) and SIT (
P
= 0.005) compared to CTRL. Total PYY increased more immediately post-exercise in males than females (
P
= 0.030). GLP-1 only increased in females following MICT (
P
= 0.034) and SIT (
P
= 0.024) compared to CTRL. Perceived hunger was lower immediately post-MICT (
P
= 0.016) and SIT (
P
= 0.006) compared to CTRL.
Conclusions
These results suggest that total PYY and GLP-1 respond differently to exercise in males and females over 90 min following various exercise intensities. The observed post-exercise hormonal response would not be expected to create a compensatory increase in energy intake in females.
Reach-to-grasp movements feature the integration of a reach directed by the extrinsic (location) features of a target and a grasp directed by the intrinsic (size, shape) features of a target. The ...action-perception theory suggests that integration and scaling of a reach-to-grasp movement, including its trajectory and the concurrent digit shaping, are features that depend upon online action pathways of the dorsal visuomotor stream. Scaling is much less accurate for a pantomime reach-to-grasp movement, a pretend reach with the target object absent. Thus, the action-perception theory proposes that pantomime movement is mediated by perceptual pathways of the ventral visuomotor stream. A distinguishing visual feature of a real reach-to-grasp movement is gaze anchoring, in which a participant visually fixates the target throughout the reach and disengages, often by blinking or looking away/averting the head, at about the time that the target is grasped. The present study examined whether gaze anchoring is associated with pantomime reaching. The eye and hand movements of participants were recorded as they reached for a ball of one of three sizes, located on a pedestal at arms’ length, or pantomimed the same reach with the ball and pedestal absent. The kinematic measures for real reach-to-grasp movements were coupled to the location and size of the target, whereas the kinematic measures for pantomime reach-to-grasp, although grossly reflecting target features, were significantly altered. Gaze anchoring was also tightly coupled to the target for real reach-to-grasp movements, but there was no systematic focus for gaze, either in relation with the virtual target, the previous location of the target, or the participant’s reaching hand, for pantomime reach-to-grasp. The presence of gaze anchoring during real vs. its absence in pantomime reach-to-grasp supports the action–perception theory that real, but not pantomime, reaches are online visuomotor actions and is discussed in relation with the neural control of real and pantomime reach-to-grasp movements.
Numerous studies have found negative outcomes between shift work and physical, emotional, and mental health. Many professional caregivers are required to work shifts outside of the typical 9 am to 5 ...pm workday. Here, we explore whether shift work affects the health and wellbeing of long-term care (LTC) and assisted-living (AL) professional caregivers.
The Caring for Professional Caregivers research study was conducted across 39 LTC and AL facilities in Alberta, Canada. Of the 1385 questionnaires distributed, 933 surveys (67.4%) were returned completed. After identifying 49 questions that significantly explained variances in the reported health status of caregivers, we examined whether there was a relationship between these questions and reported health status of caregivers working night shifts.
We found significant differences between responses from those working different shifts across six of seven domains, including physical health, health conditions, mental/emotional health, quality of life, and health behaviors. In particular, we found that night shift caregivers were more likely to report incidents of poor heath (i.e., they lacked energy, had regular presences of neck and back pain, regular or infrequent incidents of fatigue or low energy, had difficulty falling asleep, and that they never do exercise) and less likely to report incidents of good health (i.e., did not expect their health to improve, were not satisfied with their health, do not have high self-esteem/were happy, were unhappy with their physical appearance, and do not get a good night's sleep), compared to caregivers working other shifts.
Our study shows that professional caregivers working the night shift experience poor health status, providing further evidence that night shift workers' health is at risk. In particular, caregivers reported negative evaluations of their physical, mental/emotional health, lower ratings of their quality of life, and negative responses to questions concerning whether they engage in healthy behaviors. Our findings can support healthcare stakeholders outline future policies that ensure caregivers are adequately supported so that they provide quality care.
Behavior provides important insights into neuronal processes. For example, analysis of reaching movements can give a reliable indication of the degree of impairment in neurological disorders such as ...stroke, Parkinson disease, or Huntington disease. The analysis of such movement abnormalities is notoriously difficult and requires a trained evaluator. Here, we show that a deep neural network is able to score behavioral impairments with expert accuracy in rodent models of stroke. The same network was also trained to successfully score movements in a variety of other behavioral tasks. The neural network also uncovered novel movement alterations related to stroke, which had higher predictive power of stroke volume than the movement components defined by human experts. Moreover, when the regression network was trained only on categorical information (control = 0; stroke = 1), it generated predictions with intermediate values between 0 and 1 that matched the human expert scores of stroke severity. The network thus offers a new data-driven approach to automatically derive ratings of motor impairments. Altogether, this network can provide a reliable neurological assessment and can assist the design of behavioral indices to diagnose and monitor neurological disorders.
Abstract Objective The objectives of this study were to determine if faction membership among Canadian doctors of chiropractic (DCs) is associated with differences in educational program ...characteristics among English-speaking Canadian and United States chiropractic colleges and to determine if those differences are expressed in terms of surveyed attitudes and behaviors regarding treatment efficacy, radiographic imaging, vaccinations, and interprofessional referrals. This study also aims to identify if educational programs may be a potential source of multiple professional identities. Methods A randomly selected sample of Canadian DCs, stratified across the English-speaking provinces, was surveyed by mail. Survey items included school of graduation, self-categorization by chiropractic subgroup, perceptions of condition-specific treatment efficacy, use of plain film radiographic imaging, vaccination attitudes/behaviors, and patient referral patterns. Self-categorization by chiropractic subgroup included: the unorthodox faction (associates the chiropractic subluxation as an encumbrance to the expression of health) and the orthodox perspective (associates with musculoskeletal joint dysfunction, public health, and lifestyle concerns). For data analysis, chiropractic schools were divided into 2 groups according to location: English-speaking Canada and the US. The US was further clustered into liberal (“interested in mixing elements of modern and alternative therapies into the practice of chiropractic") and conservative categories (“chiropractors who believe in continuing the traditions of chiropractic"). Results Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. χ2 Testing revealed significant differences in self-categorized faction membership associated with the clustering of colleges based on ideological viewpoints ( χ2 = 27.06; P = .000). Descriptive results revealed a relationship between school of origin and perceived treatment efficacy, use of radiographic imaging, and vaccination attitudes. No significant differences were found relative to interprofessional referral patterns. Conclusion Chiropractic program attended is a significant predictor of orthodox vs unorthodox faction membership and professional practice characteristics for Canadian DCs. This suggests that the current chiropractic education system may contribute to multiple professional identities.
This study explored the viability and efficacy of integrating cadence-matched, salient music into a walking intervention for patients with Parkinson's disease (PD). Twenty-two people with PD were ...randomised to a control (CTRL, n=11) or experimental (MUSIC, n=11) group. MUSIC subjects walked with an individualised music playlist three times a week for the intervention period. Playlists were designed to meet subject's musical preferences. In addition, the tempo of the music closely matched (±10–15 bpm) the subject's preferred cadence. CTRL subjects continued with their regular activities during the intervention. The effects of training accompanied by “walking songs” were evaluated using objective measures of gait score. The MUSIC group improved gait velocity, stride time, cadence, and motor symptom severity following the intervention. This is the first study to demonstrate that music listening can be safely implemented amongst PD patients during home exercise.
PDF
