Efficacy of progressive aquatic resistance training for tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis: a randomised controlled trial

OBJECTIVE: To study the efficacy of aquatic resistance training on biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA).

DESIGN: Eighty seven volunteer postmenopausal women, aged 60-68 years, with mild knee OA (Kellgren-Lawrence grades I/II and knee pain) were recruited and randomly assigned to an intervention (n = 43) and control (n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessions over 16 weeks while the control group maintained usual level of physical activity. The biochemical composition of the medial and lateral tibiofemoral cartilage was estimated using single-slice transverse relaxation time (T2) mapping and delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC index). Secondary outcomes were cardiorespiratory fitness, isometric knee extension and flexion force and knee injury and OA outcome (KOOS) questionnaire.

RESULTS: After 4-months aquatic training, there was a significant decrease in both T2 -1.2 ms (95% confidence interval (CI): -2.3 to -0.1, P = 0.021) and dGEMRIC index -23 ms (-43 to -3, P = 0.016) in the training group compared to controls in the full thickness posterior region of interest (ROI) of the medial femoral cartilage. Cardiorespiratory fitness significantly improved in the intervention group by 9.8% (P = 0.010).

CONCLUSIONS: Our results suggest that, in postmenopausal women with mild knee OA, the integrity of the collagen-interstitial water environment (T2) of the tibiofemoral cartilage may be responsive to low shear and compressive forces during aquatic resistance training. More research is required to understand the exact nature of acute responses in dGEMRIC index to this type of loading. Further, aquatic resistance training improves cardiorespiratory fitness.

Simulation of progressive damage in composites using the enhanced embedded element technique

Analysis of complex composite structures requires a fine contiguous mesh of threedimensional (3D) solid elements. The embedded element technique is a promising technique for predicting stiffness and stress. This paper presents a new method for enhancing the embedded element with continuum damage mechanics methods for predicting the evolution of damage in fiber reinforced composite structures. Comparison of the model prediction with experimental results reveals an excellent correlation between the tensile strength of quasi-isotropic laminate with an open hole. The embedded element technique allows the fiber reinforcement and matrix domains to be meshed independently and failure is evaluated separately in each domain. The enhanced embedded element approach allows the failure modes to be observed, specifically, the evolution of matrix cracking and fiber rupture. Compared to the traditional contiguous mesh finite element method, the present modelling technique demonstrates a clear advantage in predicting the experimentally observed failure modes and accurate characterisation of intralaminar fracture.

Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson's disease: study protocol for a randomised controlled trial

BACKGROUND: Parkinson's disease (PD) results from a loss of dopamine in the brain, leading to movement dysfunctions such as bradykinesia, postural instability, resting tremor and muscle rigidity. Furthermore, dopamine deficiency in PD has been shown to result in maladaptive plasticity of the primary motor cortex (M1). Progressive resistance training (PRT) is a popular intervention in PD that improves muscular strength and results in clinically significant improvements on the Unified Parkinson's Disease Rating Scale (UPDRS). In separate studies, the application of anodal transcranial direct current stimulation (a-tDCS) to the M1 has been shown to improve motor function in PD; however, the combined use of tDCS and PRT has not been investigated.

METHODS/DESIGN: We propose a 6-week, double-blind randomised controlled trial combining M1 tDCS and PRT of the lower body in participants (n = 42) with moderate PD (Hoehn and Yahr scale score 2-4). Supervised lower body PRT combined with functional balance tasks will be performed three times per week with concurrent a-tDCS delivered at 2 mA for 20 minutes (a-tDCS group) or with sham tDCS (sham group). Control participants will receive standard care (control group). Outcome measures will include functional strength, gait speed and variability, balance, neurophysiological function at rest and during movement execution, and the UPDRS motor subscale, measured at baseline, 3 weeks (during), 6 weeks (post), and 9 weeks (retention). Ethical approval has been granted by the Deakin University Human Research Ethics Committee (project number 2015-014), and the trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001241527).

DISCUSSION: This will be the first randomised controlled trial to combine PRT and a-tDCS targeting balance and gait in people with PD. The study will elucidate the functional, clinical and neurophysiological outcomes of combined PRT and a-tDCS. It is hypothesised that combined PRT and a-tDCS will significantly improve lower limb strength, postural sway, gait speed and stride variability compared with PRT with sham tDCS. Further, we hypothesise that pre-frontal cortex activation during dual-task cognitive and gait/balance activities will be reduced, and that M1 excitability and inhibition will be augmented, following the combined PRT and a-tDCS intervention.

Feminist struggles to mobilise progressive spaces within the ‘boy-turn’ in gender equity and schooling reform

This article presents the stories of two Australian feminist educators, ‘Kath’ and ‘Kim’. Drawn from a small‐scale interview‐based study, the stories highlight these women’s struggles to mobilise progressive spaces within the current boy‐focused equity and schooling agenda. Such struggles are located within the new possibilities for feminist intervention enabled by current educational trends in Australia. The stories focus on Kath and Kim’s experiences leading the professional development of teachers from several schools in Queensland (Australia) as part of the $19.4 million national initiative, Success for Boys. The article draws on feminist understandings of ‘progressive’ spaces and highlights the requisite conditions necessary for mobilising such spaces. In particular, Kath and Kim’s stories bring to light the powerful role emotions continue to play in both enabling and constraining gender reform and the continued significance of attending to, and working with, such emotions to enhance the pursuit of gender justice in schools.