6-week Protocol Research Articles

Influence of Acute and Chronic Therapeutic Cooling on Cognitive Performance and Well-being

PurposeResearch regarding the effect cold-water immersion (CWI) has on cognitive performance often uses excessive cooling protocols (>1-hour) to measure the detrimental impact prolonged cold exposure has on cognition. Previous studies have not considered shorter CWI protocols, similar to that used in recovery and wellness practices (∼10 min). AimsTo investigate a more ecologically valid CWI protocol on cognition, well-being and sleep in an acute and chronic manner. It was hypothesised that a therapeutic CWI protocol would improve well-being, and sleep and have no detrimental effect on cognition. MethodsThirteen healthy participants (20.85±2.15 years), (169.96±7.77 cm), (72.03±14.92 kg), (27.67±9.55 BF%) volunteered to complete a 4-week CWI protocol. Participants were immersed in cold water (10.42±0.59°C) 3-times a week for 4-weeks. Cognitive performance (Stroop & TMT), well-being (WEMWBS, PSWQ, GAD-7, SHS) and sleep (PSQI) were measured acutely and chronically over the 4-week protocol along with thermoregulatory measures (Tsk, Tco, thermal comfort). ResultsResults show that CWI had no detrimental impact on cognitive performance, with Stroop performance & well-being seeing no differences acutely or chronically. Alternatively, the trail making test showed significant improvement from baseline (TMT-A 15.17±4.81-seconds, TMT-B 39.68±15.12-seconds) to week-3 (TMT-A 11.06±3.29-seconds, TMT-B 26.18±10.23-seconds). A reduction in sleep disturbances was seen from baseline scores of 7.85±3.44 AU to the end of week-3 measures 5.75±3.77 AU. ConclusionTherapeutic cooling can improve sleep quality when utilised in short frequent doses (3 times per week, for 4-weeks) and is not detrimental to cognitive performance, improving certain aspects of executive function.

Vaginismus: Results from Treatment with the PRM Protocol™

Background/Aim: Vaginismus, a condition characterized by involuntary pelvic floor muscle spasms, presents considerable challenges in diagnosis and treatment, impacting sexual health and quality of life. This study evaluates the efficacy of a novel pelvic peripheral nerve block and trigger point injection protocol (the PRM Protocol™) in addressing vaginismus. Materials/Methods: A retrospective chart review of 961 patients diagnosed with vaginismus, aged 18-76, was conducted. Participants underwent a 6-week treatment protocol involving neuromuscular treatment and physical therapy. Results: Outcome measures included the Visual Analog Scale (VAS) pain scale, the Functional Pelvic Pain Scale (FPPS), and the modified Sexual Function Profile (SFP). Post-treatment, there were notable decreases in VAS by 46%, FPPS by 51% and a 25% improvement in SFP. Additionally, opioid use decreased by 22%, ER visits decreased by 18%, and absenteeism and presenteeism decreased by 56% and 68%, respectively. No adverse events were reported. Conclusion: The study highlights the comprehensive efficacy of the PRM Protocol™ in alleviating vaginismus symptoms and improving patient outcomes. Implementation of this protocol offers a transformative opportunity to enhance patient care and optimize resource allocation in managing vaginismus, warranting further research and clinical application.

Momentary awareness of body sensations is associated with concurrent affective experience.

Affect is thought to be a low-dimensional representation of ongoing body activity. Recent studies have demonstrated that individual differences in the ability to objectively detect one's body activity are related to affective experience, particularly the experience of affective arousal. However, less is known about the role of subjective awareness of body sensations in affective experience, a facet of interoception that has been distinguished from objective detection on theoretical and empirical grounds. Moreover, there is a lack of evidence concerning how affective experience relates to the perception of body activity in the moment; that is, how awareness of sensations from the body may covary with affective and emotional experiences in real time. In the present studies, we examine within-person relationships between subjective awareness of body sensations and self-reported affect in real-world settings using ecological momentary assessment (EMA) paradigms. Across two EMA studies with international samples of adults, we found participants reported greater awareness of body sensations in moments where they also reported experiencing heightened arousal and more negatively valenced affect. In Study 1 (N = 109; data collected and analyzed 2022), we found that the associations held across a 4-week EMA protocol. In Study 2 (N = 116; data collected 2020, analyzed 2022), we also derived measures of affective valence from participants' freely generated descriptions of their ongoing thoughts, and we explored the consistency of this relationship with awareness of several individual body sensations (e.g., awareness of one's breathing, awareness of one's heart rate). We conclude that affective experience covaries moment to moment with subjective awareness of the body. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

P102 PH-SENSOR GPR68 PLAYS A ROLE IN THE CARDIOPROTECTIVE EFFECTS OF A HIGH FIBRE DIET

Background/Objective: Dietary fibre lowers blood pressure (BP) via short-chain fatty acids, acidic metabolites released from fibre fermentation by the bacteria in the large intestine. This acidic microenvironment may activate pH-sensing receptor GPR68, expressed primarily on immune cells, which play a crucial role in BP regulation. Here, we aimed to investigate whether GPR68 confers the cardioprotective effects of a high-fibre diet in hypertension by regulating inflammatory responses. Methods: 6–8-week-old male wildtype (WT) and GPR68-deficient (Gpr68-/-) fed a control or high-fibre diet underwent subcutaneous implantation of minipumps containing Angiotensin II (0.75 mg/kg body weight/day, 4 weeks, n=8/group). BP was measured weekly by tail-cuff. Morphometric, histological, and flow cytometric analyses were performed following the 4-week protocol. Results: High-fibre-fed WT mice exhibited blunted elevations in systolic BP (week 4; p=0.0508) and lower cardiac interstitial collagen deposition (p=0.0495) compared to WT mice fed a control diet. However, high fibre did not lower BP (week 4; control vs high-fibre, p=0.689) or cardiac collagen deposition (p=0.842) in Gpr68-/- mice. High-fibre-fed WT mice exhibited improved aortic elastin content compared to control-fed WT mice (p=0.0503), whereas this remained negligible in Gpr68-/- mice (p=0.885). Flow cytometric analysis revealed that high fibre decreased aortic macrophage (p=0.0072) and neutrophil cell counts (p=0.0273) in mice, irrespective of genotype. High fibre also decreased overall renal immune cell counts (p=0.0213) and dendritic cells (p=0.0488) in mice, irrespective of genotype. Finally, high fibre-fed mice had overall decreased circulating immune cell counts (p=0.0264), specifically CD8+ T cells (p=0.0235), and γδ T cells (p=0.0264). Conclusions: High fibre intervention on Angiotensin II-treated GPR68-deficient mice did not lower their BP or cardiac fibrosis. All angiotensin II-treated mice fed a high-fibre diet exhibited prominent changes in various immune cell populations, irrespective of genotype. Nonetheless, this study provides novel insight that GPR68 is involved in the cardioprotective effects of a high-fibre diet. This is most likely via in an immune-independent manner, warranting further investigations into its underlying mechanisms of action.

Treadmill exercise in combination with acousto-optic and olfactory stimulation improves cognitive function in APP/PS1 mice through the brain-derived neurotrophic factor- and Cygb-associated signaling pathways.

A reduction in adult neurogenesis is associated with behavioral abnormalities in patients with Alzheimer's disease. Consequently, enhancing adult neurogenesis represents a promising therapeutic approach for mitigating disease symptoms and progression. Nonetheless, non-pharmacological interventions aimed at inducing adult neurogenesis are currently limited. Although individual non-pharmacological interventions, such as aerobic exercise, acousto-optic stimulation, and olfactory stimulation, have shown limited capacity to improve neurogenesis and cognitive function in patients with Alzheimer's disease, the therapeutic effect of a strategy that combines these interventions has not been fully explored. In this study, we observed an age-dependent decrease in adult neurogenesis and a concurrent increase in amyloid-beta accumulation in the hippocampus of amyloid precursor protein/presenilin 1 mice aged 2-8 months. Amyloid deposition became evident at 4 months, while neurogenesis declined by 6 months, further deteriorating as the disease progressed. However, following a 4-week multifactor stimulation protocol, which encompassed treadmill running (46 min/d, 10 m/min, 6 days per week), 40 Hz acousto-optic stimulation (1 hour/day, 6 days/week), and olfactory stimulation (1 hour/day, 6 days/week), we found a significant increase in the number of newborn cells (5'-bromo-2'-deoxyuridine-positive cells), immature neurons (doublecortin-positive cells), newborn immature neurons (5'-bromo-2'-deoxyuridine-positive/doublecortin-positive cells), and newborn astrocytes (5'-bromo-2'-deoxyuridine-positive/ glial fibrillary acidic protein-positive cells). Additionally, the amyloid-beta load in the hippocampus decreased. These findings suggest that multifactor stimulation can enhance adult hippocampal neurogenesis and mitigate amyloid-beta neuropathology in amyloid precursor protein/presenilin 1 mice. Furthermore, cognitive abilities were improved, and depressive symptoms were alleviated in amyloid precursor protein/presenilin 1 mice following multifactor stimulation, as evidenced by Morris water maze, novel object recognition, forced swimming test, and tail suspension test results. Notably, the efficacy of multifactor stimulation in consolidating immature neurons persisted for at least 2 weeks after treatment cessation. At the molecular level, multifactor stimulation upregulated the expression of neuron-related proteins (NeuN, doublecortin, postsynaptic density protein-95, and synaptophysin), anti-apoptosis-related proteins (Bcl-2 and PARP), and an autophagy-associated protein (LC3B), while decreasing the expression of apoptosis-related proteins (BAX and caspase-9), in the hippocampus of amyloid precursor protein/presenilin 1 mice. These observations might be attributable to both the brain-derived neurotrophic factor-mediated signaling pathway and antioxidant pathways. Furthermore, serum metabolomics analysis indicated that multifactor stimulation regulated differentially expressed metabolites associated with cell apoptosis, oxidative damage, and cognition. Collectively, these findings suggest that multifactor stimulation is a novel non-invasive approach for the prevention and treatment of Alzheimer's disease.

Gamified delivery of at-home rehabilitation for individuals with nonspecific low back pain: a randomized controlled trial

Purpose To measure the change in pain and disability during and after a 6-week gamified delivery of home exercise compared to a take-home packet. Materials and Methods A 6-week at-home exercise protocol included participants randomly allocated to a gamified delivery group or packet group. The exercise protocol included the plank, side plank, foot elevated side plank, dead bug, and bird dog completed until discontinuation. The gamified delivery group received on-demand exercise videos and weekly exercise duration leaderboards. The packet group received a take-home packet. Results Forty participants were randomized into a packet group and leaderboard group, and 30 participants completed the study. Disability was significantly lower at 6-weeks (11.29 ± 9.81%) compared to baseline (15.93 ± 11.65%) in the packet group (χ2(2) =10.89, Z= −3.163, p=.002, r=.708). Percent disability was significantly lower at 6-weeks (8.00 ± 5.91%) compared to baseline (13.01 ± 7.17%) in the gamified delivery group (χ2(2) =13.235, Z= −3.399, p= <.001, r= −0.760). Worst pain was higher at baseline (7.05 ± 1.61%) than at 6-weeks (5.75 ± 1.68%) in the packet group (χ2(2) =8.067, Z = 2.760, p=.006, r= −0.617). Worst pain was higher at baseline (6.90 ± 1.33%) than at 6-weeks (5.24 ± 2.38%) in the gamified delivery group (χ2(2) =6.250, Z= −2.810, p=.005, r= −0.628). No significant difference in the change of disability from baseline to 6 weeks was found between groups (p=.483). Conclusions Core exercises completed until failure may improve disability and pain at 6-weeks and positively influence perceived patient improvement. Registry: Clinicaltrials.gov; Registration number: NCT05573932

Feasibility and Acceptability of a Mobile App-Based TEAM-CBT (Testing Empathy Assessment Methods-Cognitive Behavioral Therapy) Intervention (Feeling Good) for Depression: Secondary Data Analysis.

The Feeling Good App is an automated stand-alone digital mobile mental health tool currently undergoing beta testing with the goal of providing evidence-informed self-help lessons and exercises to help individuals reduce depressive symptoms without guidance from a mental health provider. Users work through intensive basic training (IBT) and ongoing training models that provide education regarding cognitive behavioral therapy principles from a smartphone. The key objective of this study was to perform a nonsponsored third-party academic assessment of an industry-generated data set; this data set focused on the safety, feasibility, and accessibility of a commercial automated digital mobile mental health app that was developed to reduce feelings associated with depression. The Feeling Good App development team created a waitlist cohort crossover design and measured symptoms of depression and anxiety using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and an app-specific measure of negative feelings called the 7 Dimension Emotion Slider (7-DES). The waitlist cohort crossover design divided the participants into 2 groups, where 48.6% (141/290) of the participants were given immediate access to the apps, while 51.4% (149/290) were placed on a 2-week waitlist before being given access to the app. Data collected by the Feeling Good App development team were deidentified and provided to the authors of this paper for analysis through a nonsponsored university data use agreement. All quantitative data were analyzed using SPSS Statistics (version 28.0; IBM Corp). Descriptive statistics were calculated for demographic variables. Feasibility and acceptability were descriptively assessed. All participants included in the quantitative data were given access to the Feeling Good App; this study did not include a control group. In terms of safety, there was no statistically significant change in suicidality from preintervention to postintervention time points (t288=0.0; P>.99), and there was a statistically significant decrease in hopelessness from preintervention to postintervention time points (F289=30.16; P<.01). In terms of acceptability, 72.2% (166/230) of the users who started the initial 2-day IBT went on to complete it, while 34.8% (80/230) of the users who started IBT completed the entirety of the apps' 4-week protocol (150/230, 65.22% dropout rate over 4 weeks). This study is the first reported proof-of-concept evaluation of the Feeling Good App in terms of safety, feasibility, and statistical trends within the data set. It demonstrates a feasible and novel approach to industry and academic collaboration in the process of developing a digital mental health technology translated from an existing evidence-informed treatment. The results support the prototype app as safe for a select nonclinical population. The app had acceptable levels of engagement and dropouts throughout the intervention. Those who stay engaged showed reductions in symptom severity of depression warranting further investigation of the app's efficacy.

Synergistic effects of melatonin and hydrogen sulfide in alleviating cognitive decline and BDNF dysregulation in a rat model of depression

ABSTRACT This research aimed to investigate the possible anti-amnesic effects of a combined therapy involving melatonin and H2S in a rat model displaying Depressive-Like Behaviors caused by Chronic Unpredictable Mild Stress (CUMS). Our study aims to assess the efficacy of this treatment in mitigating oxidative stress and neuroinflammation in the striatum and hippocampus. Furthermore, we seek to investigate its ability to restore BDNF levels within this specific rat model. The rats underwent a 4-week CUMS protocol and were administered sodium hydrosulfide (a H2S donor) at a dose of 5.6 μmol/100 g/day, as well as melatonin at a dose of 1 mg/100 g/day from the first day of the CUMS protocol. Following the CUMS exposure, the rats were assessed through various behavioral tests. Subsequently, the rats were euthanized after the behavioral tests, and blood samples were collected for corticosterone analysis. Oxidative stress (OS) markers, BDNF and TNF-α levels were analyzed in both the striatum and HP. Concurrently administering H2S and melatonin in a rat model of CUMS-induced depression demonstrates antidepressant-like effects. Furthermore, this combined treatment effectively prevents the development of learning and memory impairments associated with CUMS. Additionally, it reduces Malondialdehyde and nitric oxide levels, enhances glutathione peroxidase and superoxide dismutase activity in the striatum and HP, and mitigates CUMS-induced elevations in TNF-α levels in both brain regions. Significantly, long-term administration of this combination reverses the chronic stress-induced reduction of hippocampal BDNF levels. These findings suggest that the synergy between H2S and melatonin holds promise in alleviating cognitive impairments.

Effect of whole-body vibration frequency on objective physical function outcomes in healthy young adults: Randomized clinical trial

IntroductionWhole-body vibration (WBV) is used to improve muscle function but is important to know if doses can affect the objective function outcomes. ObjectiveTo compare the effect of two frequencies of WBV on objective physical function outcomes in healthy young adults. MethodsForty-two volunteers were randomized into three groups: sham group (SG), and WBV groups with 30 (F30) and 45 Hz (F45). A 6-week WBV intervention protocol was applied by a vibrating platform twice a week, with the platform turn-off for SG and with two frequencies according to group, 30 or 45 Hz. The objective physical functions outcomes assessed were the proprioceptive accuracy, measured by proprioceptive tests, and quasi-static and dynamic balances, measured by Sensory Organization Test (SOT) and Y Balance Test, respectively. The outcomes were assessed before and after the WBV intervention. We used in the results comparisons, by GzLM test, the deltas percentage. ResultsAfter the intervention, no statistical differences were observed in percentage deltas for any outcomes (proprioceptive accuracy, quasi-static and dynamic balances). ConclusionObjective physical function outcomes, after the 6-week WBV protocol, did not present statistically significant results in any of the intervention groups (F30 or F45) and SG.

Sex-Specific Differences and the Role of Environmental Enrichment in the Expression of Hippocampal CB1 Receptors following Chronic Unpredictable Stress.

Stress-related mental disorders have become increasingly prevalent, thus endangering mental health worldwide. Exploring stress-associated brain alterations is vital for understanding the possible neurobiological mechanisms underlying these changes. Based on existing evidence, the brain endogenous cannabinoid system (ECS) plays a significant role in the stress response, and disruptions in its function are associated with the neurobiology of various stress-related disorders. This study primarily focuses on investigating the impact of chronic unpredictable stress (CUS) on the expression of hippocampal cannabinoid type 1 (CB1) receptors, part of the ECS, in adult male and female Wistar rats. Additionally, it explores whether environmental enrichment (EE) initiated during adolescence could mitigate the CUS-associated alterations in CB1 expression. Wistar rats, shortly after weaning, were placed in either standard housing (SH) or EE conditions for a duration of 10 weeks. On postnatal day 66, specific subgroups of SH or EE animals underwent a 4-week CUS protocol. Western blot (WB) analysis was conducted in the whole hippocampus of the left brain hemisphere to assess total CB1 protein expression, while immunohistochemistry (IHC) was performed on the right hemisphere to estimate the expression of CB1 receptors in certain hippocampal areas (i.e., CA1, CA3 and dentate gyrus-DG). The WB analysis revealed no statistically significant differences in total CB1 protein levels among the groups; however, reduced CB1 expression was found in specific hippocampal sub-regions using IHC. Specifically, CUS significantly decreased CB1 receptor expression in the CA1 and DG of both sexes, whereas in CA3 the CUS-associated decrease was limited to SH males. Interestingly, EE housing proved protective against these reductions. These findings suggest a region and sex-specific endocannabinoid response to chronic stress, emphasizing the role of positive early experiences in the protection of the adolescent brain against adverse conditions later in life.

Early-life exposure to sex hormones promotes voluntary ethanol intake in adulthood. A vulnerability factor to drug addiction.

While there is extensive research on alcohol dependence, the factors that make an individual vulnerable to developing alcoholism haven't been explored much. In this study, we aim to investigate how neonatal exposure to sex hormones affects alcohol intake and the regulation of the mesolimbic pathway in adulthood.The study aimed to investigate the impact of neonatal exposure to a single dose of testosterone propionate (TP) or estradiol valerate (EV) on ethanol consumption in adult rats. The rats were subjected to a two-bottle free-choice paradigm, and the content of dopamine (DA) and 3,4-dihydroxyphenylacetic acid (DOPAC) in the nucleus accumbens (NAcc) was measured using HPLC-ED. The expression of critical DA-related proteins in the mesolimbic pathway was evaluated through RT-qPCR and western blot analysis.Supraphysiological neonatal exposure to EV or TP resulted in increased ethanol intake over four weeks in adulthood. In addition, the DA and DOPAC content was reduced and increased in the NAcc of EV and TP-treated rats, and β-endorphin content in the hypothalamus decreased in EV-treated rats. The VTA μ receptor and DA type 2 form short receptor (D2S) expression were significantly reduced in EV and TP male rats. Finally, in an extended 6-week protocol, the increase in ethanol consumption induced by EV was mitigated during the initial two hours post-naloxone injection.Neonatal exposure to sex hormones is a detrimental stimulus for the brain, which can facilitate the development of addictive behaviors, including alcohol use disorder.

Biological variation of PIVKA-II in blood serum of healthy subjects measured by automated electrochemiluminescent assay

BackgroundProthrombin/Protein Induced by Vitamin K Absence-II (PIVKA-II) is a candidate biomarker of hepatocellular cancer, recommended both for diagnostics and monitoring. The aim was to evaluate biological variation (BV) of serum PIVKA-II. MethodsWithin-subject (CVI) and between-subject (CVG) BV estimates were assessed in 14 healthy volunteers in a 6-week protocol. Serum concentrations of PIVKA-II were measured by a Roche Elecsys PIVKA-II diagnostic kit (cobas e8000). Precision (CVA) was assessed from duplicate measurements of all volunteers' samples. Two methods were used for the estimation of CVI: SD-ANOVA and CV-ANOVA method. We calculated the index of individuality (II) and reference change value. The experiment was fully compliant with EFLM database checklist. ResultsThe CVI of PIVKA-II in healthy persons, as calculated by two statistical methods, were 8.2% (SD-ANOVA with CVA of 3.2%) and 9.4% (CV-ANOVA) with CVA of 2.7%). The CVG was 19.5% (SD-ANOVA), and respective II and RCV were 0.42 and 24.4%. ConclusionsCVI and CVG of PIVKA-II were 8.2% and 19.5%, respectively, with CVA below 4%. The low II and RCV below 25% enable the use of this biomarker both for diagnostics and monitoring. More data are needed before the introduction of PIVKA-II into clinical practice.

IMPROVE study protocol, investigating post-stroke local muscle vibrations to promote cerebral plasticity and functional recovery: a single-blind randomised controlled trial

IntroductionSpasticity is a frequent disabling consequence following a stroke. Local muscle vibrations (LMVs) have been proposed as a treatment to address this problem. However, little is known about their clinical...

The Effect of Task-oriented Training Combined with Scapular Stabilization Exercises on Paretic Upper Extremity Function in Patient with Stroke: A Case Study

A stroke (cerebrovascular accident) is the rapid loss of neurological function brought on by an interruption in blood flow to the brain. Over 85% of stroke patients undergo hemiplegia, and more than 69% of them experience an upper limb motor function deficit. In this case report, a 68-year-old male was assessed for stroke; his upper extremity (UE) function was assessed using the manual function test, Fugl-Meyer Assessment UE, and Wolf Motor Function Test (WMFT) time. The patient underwent a 4-week treatment protocol that included task-oriented training (TOT) and scapular stabilization exercises. Post 4th week there was significant improvemnet observed in the paretic upper extremity (UE) function, that was assessed using manual functional test, Fugl-Meyer Assessment UE, WMFT time scores.

The Feasibility and Effects of Self-Acupressure on Symptom Burden and Quality of Life in Hemodialysis Patients: A Pilot RCT.

Symptom burden among long-term hemodialysis (HD) patients is high, and addressing symptoms has been identified as a key research priority by patients. Acupressure has shown some effectiveness in management of symptoms in patients with HD. The purpose of this study was to explore the feasibility and the effect of implementing a self-administered acupressure intervention on symptom burden and quality of life for in-center HD patients. A pilot randomized controlled study. Two outpatient community HD clinics between in Calgary, Alberta, Canada. Patients on HD for at least 3 months and with at least one symptom score rated greater than moderate were eligible for the study. Participants were randomized into either the (1) self-acupressure + usual care or (2) usual care alone group. Participants in the acupressure group were given a wooden acupressure tool and taught how to self-administer protocol on 6 acupressure sites for the 4-weeek study duration. Feasibility outcomes were assessed through satisfaction surveys and attrition. Other outcomes included quality of life and symptom scores by validated questionnaires (EQ-5D-5L and Integrated Palliative Outcome Score-Renal [IPOS-Renal]). Thirty-two participants were successfully enrolled in the study; acceptability was high with study completion at 98% in the intervention group and 82% adherence rate to the 4-week protocol. Participants in the intervention group reported an improved change score in quality of life (EQ-5D-5L Index Score change = +0.053; EQ-5D-5L visual analog scale score change = +6.7). Participants in the intervention group also reported improved symptom scores (IPOS-Renal overall change = -2.8). Small sample size and intervention duration are limitations of this pilot study. The results from this study suggest that self-acupressure was acceptable and feasible in this sample of HD patients. Self-acupressure may have a role for supporting the management of symptoms in HD patients. These pilot results can be used to inform larger more definitive investigations.

Ab. No. 158 Lack of Rural Rehab: A Case Report of Chronic Stiffness Post Tibia Fracture

Introduction: Even after 7 decades, referral depends on acceptance of physiotherapy as an independent profession. Even if prescribed, rural rehabilitation is not always executed with regular follow up.Neither documentation of rural physiotherapist-population ratio requirements, nor regulatory body to standardize rehabilitation level is available. Only 3% Anganwadi workers were informed about physiotherapy, though Maharashtra has 214 PHCs with wellness room for physiotherapy/yoga. Regain quality of life, return to employment, which was lacking a year after proximal tibial fracture, due to lack of referral to post-operative physiotherapy in Maharashtra’s Mangaon taluka. Methods: A 41-year-old patient with right undisplaced lateral tibial condyle fracture complained of limited knee range, stiffness, pain on standing, prolonged sitting, stairclimbing, reduced walking speed, loss of job as a coal miner. He was explained that restricted flexion was due to internal bony fragments, which caused fear of end range flexion, and was advised to undergo a revision surgery inspite of poor expected outcome. 4-week protocol included strengthening for quadriceps, hamstrings, hip abductors, flexors, calf, stretching, weight bearing exercises. Home exercises were regularly progressed. Adjuncts used were dry cupping, IASTM, dry needling. Result: Range increased from 10°-86° to 0°-112°, extensor lag, antalgic gait was corrected, thigh girth increased by 1.5 cm. Pain reduced while climbing stairs (4/10 to 0/10), standing after prolonged sitting (6/10 to 4/10), and walking (1/10 to 0/10). Squatting, cross leg sitting with minimal pain, return to work as a full-time coal miner was achieved. Revision surgery and disability were prevented. Conclusion: Rural early rehabilitative protocol could have prevented 1 year of unemployment, pain, stiffness. Implications: Highlights need for streamlined referral system to match evidence that recommends early ROM and weight bearing. Stimulate public –private partnerships for creating the role of physiotherapy assistant/technician at the existent PHCs. Facilitate followed-up tele-rehabilitation for rural physiotherapy.

Multisensory gaze stabilization in response to subchronic alteration of vestibular type I hair cells

The functional complementarity of the vestibulo-ocular reflex (VOR) and optokinetic reflex (OKR) allows for optimal combined gaze stabilization responses (CGR) in light. While sensory substitution has been reported following complete vestibular loss, the capacity of the central vestibular system to compensate for partial peripheral vestibular loss remains to be determined. Here, we first demonstrate the efficacy of a 6-week subchronic ototoxic protocol in inducing transient and partial vestibular loss which equally affects the canal- and otolith-dependent VORs. Immunostaining of hair cells in the vestibular sensory epithelia revealed that organ-specific alteration of type I, but not type II, hair cells correlates with functional impairments. The decrease in VOR performance is paralleled with an increase in the gain of the OKR occurring in a specific range of frequencies where VOR normally dominates gaze stabilization, compatible with a sensory substitution process. Comparison of unimodal OKR or VOR versus bimodal CGR revealed that visuo-vestibular interactions remain reduced despite a significant recovery in the VOR. Modeling and sweep-based analysis revealed that the differential capacity to optimally combine OKR and VOR correlates with the reproducibility of the VOR responses. Overall, these results shed light on the multisensory reweighting occurring in pathologies with fluctuating peripheral vestibular malfunction.

Multisensory gaze stabilization in response to subchronic alteration of vestibular type I hair cells.

The functional complementarity of the vestibulo-ocular reflex (VOR) and optokinetic reflex (OKR) allows for optimal combined gaze stabilization responses (CGR) in light. While sensory substitution has been reported following complete vestibular loss, the capacity of the central vestibular system to compensate for partial peripheral vestibular loss remains to be determined. Here, we first demonstrate the efficacy of a 6-week subchronic ototoxic protocol in inducing transient and partial vestibular loss which equally affects the canal- and otolith-dependent VORs. Immunostaining of hair cells in the vestibular sensory epithelia revealed that organ-specific alteration of type I, but not type II, hair cells correlates with functional impairments. The decrease in VOR performance is paralleled with an increase in the gain of the OKR occurring in a specific range of frequencies where VOR normally dominates gaze stabilization, compatible with a sensory substitution process. Comparison of unimodal OKR or VOR versus bimodal CGR revealed that visuo-vestibular interactions remain reduced despite a significant recovery in the VOR. Modeling and sweep-based analysis revealed that the differential capacity to optimally combine OKR and VOR correlates with the reproducibility of the VOR responses. Overall, these results shed light on the multisensory reweighting occurring in pathologies with fluctuating peripheral vestibular malfunction.

Is a 6-week training protocol effective in preparing young Lusitano horses in early athletic life?

Abstract A 6-weeks training program, aimed at improving the physical conditioning of dressage horses, was assessed to determine its’ effectiveness. The training program comprised of 40-80 min of daily preparatory exercises for dressage competition (transitions, circles, extended walk, trot or canter, stride length variation, diagonals, straight lines and serpentines) which were performed six times per week. Thus, nine (4 year old) Lusitano horses were evaluated before (M1) and six weeks after (M2) the introduction of the new training routine. On both occasions animals were physically examined and blood samples were collected before (T0), immediately after (T1) a dressage simulation test (DST) and at 30 min (T2) and 240 min (T3) of recovery. Heart rate (HR), respiratory rate (RR), body temperature (BT), erythrogram, blood lactate and glucose, serum proteins, albumin, aspartate aminotransferase (AST) and creatine kinase (CK) values were recorded and the obtained variables were analysed using ANOVA and Tukey tests (). The training protocol produced significant changes in the measured biomarkers. Speed of work during the DST (5.8 vs 7.36 m/s; ) significantly increased, though no changes were observed in the HRpeak (∼158.1 beat/min; ), HRmean (∼113.9 beat/min; ) and distance (∼220 m). Additionally, at M1 significantly () lower values of RR and of blood lactate were recorded and at M2 low values of HR, BT, glucose, AST and CK were observed, the latter suggesting a cardiometabolic improvement. The biomarkers returned to basal levels 30 min post DST on both M1 and M2. The training regimen successfully improved the athletic conditioning of the Lusitano horses, preparing them for the practice of dressage without compromising their welfare.

Effect of a 6-Week Preseason Training Protocol on Physiological and Muscle Damage Markers in High-Level Female and Male Basketball Players.

This study aimed to investigate the effects of a 6-week preseason functional and plyometric fitness training protocol, on physiological and biochemical markers of performance and exercise-induced muscle damage, and to compare the response of these markers between high-level female and male basketball players. The sample of the study consisted of 19 professional athletes (10 male; 9 female) competing in two different teams. The examined markers were body mass, BMI, fat percentage, speed, acceleration, explosiveness, vertical jumping ability, creatine kinase (CK) and lactate dehydrogenase (LDH). The preseason training period improved speed, acceleration, explosiveness and vertical jumping ability (~1-8%) and led to significant fat percentage reductions in both groups equivalently. CK and LDH increased similarly in both groups, and the percentage increases were higher for CK compared to LDH. Further investigation and a larger sample size are required in order to determine an approach that is more capable of maximizing performance without causing any possible injuries that may be related to muscle damage.