Resistive vibration exercise during bed-rest reduces motor control changes in the lumbo-pelvic musculature

To understand the effects of a resistive vibration exercise (RVE) countermeasure on changes in lumbo-pelvic muscle motor control during prolonged bed-rest, 20 male subjects took part in the Berlin Bed-Rest Study (in 2003-2005) and were randomised to a RVE group or an inactive control group. Surface electromyographic signals recorded from five superficial lumbo-pelvic muscles during a repetitive knee movement task. The task, which required stabilisation of the lumbo-pelvic region, was performed at multiple movement speeds and at multiple time points during and after bed-rest. After excluding effects that could be attributed to increases in subcutaneous fat changes and improvements in movement skill, we found that the RVE intervention ameliorated the generalised increases in activity ratios between movement speeds (p⩽0.012), reductions in lumbo-pelvic extensor and flexor co-contraction (p=0.058) and increases in root-mean-square electromyographic amplitude (p=0.001) of the lumbar erector spinae muscles. Effects of RVE on preventing increases in amplitude-modulation (p=0.23) of the lumbar erector spinae muscles were not significant. Few significant changes in activation-timing were seen. The RVE intervention during bed-rest, with indirect loading of the spine during exercise, was capable of reducing some, but not all, motor control changes in the lumbo-pelvic musculature during and after bed-rest.

Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain

An important aspect of neuromuscular control at the lumbo-pelvic region is stabilization. Subjects with low back pain (LBP) have been shown to exhibit impairments in motor control of key muscles which contribute to stabilization of the lumbo-pelvic region. However, a test of automatic recruitment that relates to function has been lacking. A previous study used ultrasound imaging to show that healthy subjects automatically recruited the transversus abdominis (TrA) and internal oblique (IO) muscles in response to a simulated weight-bearing task. This task has not been investigated in subjects with LBP. The aim of this study was to compare the automatic recruitment of the abdominal muscles among subjects with and without LBP in response to the simulated weight-bearing task. Twenty subjects with and without LBP were tested. Real-time ultrasound imaging was used to assess changes in thickness of the TrA and internal oblique IO muscles as well as lateral movement ("slide") of the anterior fascial insertion of the TrA muscle. Results showed that subjects with LBP showed significantly less shortening of the TrA muscle (P < 0.0001) and greater increases in thickness of the IO muscle (P = 0.002) with the simulated weight-bearing task. There was no significant difference between groups for changes in TrA muscle thickness (P = 0.055). This study provides evidence of changes in motor control of the abdominal muscles in subjects with LBP. This test may provide a functionally relevant and non-invasive method to investigate the automatic recruitment of the abdominal muscles in people with and without LBP.

The effects of rehabilitation on the muscles of the trunk following prolonged bed rest

Microgravity and inactivity due to prolonged bed rest have been shown to result in atrophy of spinal extensor muscles such as the multifidus, and either no atrophy or hypertrophy of flexor muscles such as the abdominal group and psoas muscle. These effects are long-lasting after bed rest and the potential effects of rehabilitation are unknown. This two-group intervention study aimed to investigate the effects of two rehabilitation programs on the recovery of lumbo-pelvic musculature following prolonged bed rest. 24 subjects underwent 60 days of head down tilt bed rest as part of the 2nd Berlin BedRest Study (BBR2-2). After bed rest, they underwent one of two exercise programs, trunk flexor and general strength (TFS) training or specific motor control (SMC) training. Magnetic resonance imaging of the lumbo-pelvic region was conducted at the start and end of bed rest and during the recovery period (14 and 90 days after re-ambulation). Cross-sectional areas (CSAs) of the multifidus, psoas, lumbar erector spinae and quadratus lumborum muscles were measured from L1 to L5. Morphological changes including disc volume, spinal length, lordosis angle and disc height were also measured. Both exercise programs restored the multifidus muscle to pre-bed-rest size, but further increases in psoas muscle size were seen in the TFS group up to 14 days after bed rest. There was no significant difference in the number of low back pain reports for the two rehabilitation groups (p=.59). The TFS program resulted in greater decreases in disc volume and anterior disc height. The SMC training program may be preferable to TFS training after bed rest as it restored the CSA of the multifidus muscle without generating potentially harmful compressive forces through the spine.

Self-esteem and negative affect as moderators of sociocultural influences on body dissatisfaction, strategies to decrease weight and strategies to increase muscles among adolescent boys and girls

The study was conducted to examine the impact of sociocultural influences and the moderating role of self-esteem and negative affect on body dissatisfaction and body change strategies for both adolescent boys and girls. Surveys designed to assess body dissatisfaction, body change strategies to decrease weight and increase muscles, perceived sociocultural pressures to lose weight and increase muscles, self-esteem and negative affect were administered to 587 boys and 598 girls aged between 11 and 15 years. The majority of respondents were from Anglo-Australian backgrounds (83%) with the remainder being from Asian and European non-English-speaking backgrounds. The sociocultural influences were found to significantly predict body dissatisfaction and body change strategies for both boys and girls. However, in the case of boys, self-esteem was found to moderate the impact of the sociocultural influences in predicting body change strategies. It was primarily the boys with low self-esteem who were more affected by the sociocultural pressures whereas the girls were affected independently of their self-esteem. Negative affect was also found to play a moderating role on some of the sociocultural influences in predicting strategies to increase muscles. Both boys and girls with higher levels of negative affect were more likely to be affected by sociocultural messages directed at increasing muscles. The results from the present study demonstrate that as well as examining the direct influence of sociocultural pressures, it is also important to examine how these may be moderated by self-esteem and negative affect.

Body image, strategies to change muscles and weight, and puberty. Do they impact on positive and negative affect among adolescent boys and girls?

The purpose of this study was to examine the impact of strategies to both decrease weight and increase muscle tone on negative (depression, anxiety) and positive affect among adolescent males and females. The respondents were 1185 adolescents (587 males, 598 females) who were enrolled in grades 7 and 9 (mean age for MALES=13.22 years; mean age for FEMALES=13.21 years). Respondents completed the Body Image and Body Change Inventory that assessed body image satisfaction, body image importance, body change strategies to decrease weight, body change strategies to increase muscle tone, and food supplements. Respondents also completed the Pubertal Development Scale, the depression and anxiety scales of the Depression Anxiety and Stress Scale, and the positive affect items from the Positive and Negative Affect Scale. Structural equation modelling was used to determine how body satisfaction and importance, body change strategies, and puberty impacted on depression, anxiety, and positive affect. The results demonstrated that for both boys and girls, there was a strong association between body change strategies and negative affect. For boys, body dissatisfaction did not predict negative affect, although this was a strong predictor for girls. Body change strategies did not strongly predict positive affect for either boys or girls, although body image satisfaction was a strong predictor for both genders. The implications of these findings for obtaining a better understanding of the role of pubertal development, body image, and body change strategies in predicting positive and negative affect among adolescent males and females are discussed.

Population based intervention to change back pain beliefs and disability : three part evaluation

Objective To evaluate the effectiveness of a population based, state-wide public health intervention designed to alter beliefs about back pain, influence medical management, and reduce disability and costs of compensation. Design Quasi-experimental, non-randomised, non-equivalent, before and after telephone surveys of the general population and postal surveys of general practitioners with an adjacent state as control group and descriptive analysis of claims database. Setting Two states in Australia Participants 4730 members of general population before and two and two and a half years after campaign started, in a ratio of2:1:1; 2556 general practitioners before and two years after campaign onset. Main outcome measures Back beliefs questionnaire, knowledge and attitude statements about back pain, incidence of workers' financial compensation claims for back problems, rate of days compensated, and medical payments for claims related to back pain and other claims. Results In the intervention state beliefs about back pain became more positive between successive surveys (mean improvement in questionnaire score 1.9 (95% confidence interval 1.3 to 2.5), P<0.001 and 3.2 (2.6 to 3.9), P < 0.001, between baseline and the second and third survey, respectively). Beliefs about back pain also improved among doctors. There was a clear decline in number of claims for back pain, rates of days compensated, and medical payments for claims for back pain over the duration of the campaign. Conclusions A population based strategy of provision of positive messages about back pain improves population and general practitioner beliefs about back pain and seems to influence medical management and reduce disability and workers' compensation costs related to back pain.

Back to the future : the war on terror and its impact on civil liberties

This comment looks at the capacity of the Australian Constitution to protect the civil liberties of a small number of citizens and would be citizens whose lives have been forever changed by recent acts of terror and the legislative and executive actions taken by the Commonwealth in response to those terrorist acts. These legal changes have included the creation of specific "terrorism" offences, the legislative proscription of two foreign organisations and, most notably, a significant expansion of ASIO's investigative powers.1
Whilst the Constitution contains a number of provisions and principles protective of civil liberties, in most instances they cannot resist government action expressly aimed at curtailing or infringing individual rights and freedoms. To this end, steps ought to be taken to strengthen existing institutions and mechanisms capable of providing meaningful civil rights scrutiny of government legislation. The comment begins with an examination of the close historical and legal parallels that exist between the present day and the Cold War era and suggests how the High Court might interpret the defence power should a terrorist attack occur on Australian soil. It concludes with a proposed reform. The reform involves vesting Ch III courts with the power to measure Commonwealth laws against the International Covenant on Civil and Political Rights when determining a legal controversy. This may operate to secure better legislative outcomes from a civil liberties perspective without compromising the supremacy of Parliament.

A tale of action, suspense and drama : Village Roadshow’s buy-back scheme

The experience of Village Roadshow, in its two failed attempts to have a share buy-back scheme approved by the Supreme Court, sounds a warning to companies and their legal advisers about the pitfalls in presentation of such schemes to shareholders.

A longitudinal study of body image and strategies to lose weight and increase muscles in children

A longitudinal study was used to examine age differences in the role of body mass index (BMI) and sociocultural pressures in predicting changes in body image and strategies to both lose weight and increase muscles among 443 children aged between 8 and 12 years (207 boys, 236 girls) over a 16-month period. The strongest predictors of body image and these strategies were BMI, the media and mothers, and to a lesser extent fathers and best friends. Girls were focused on losing weight, whereas boys were focused on both increasing muscle and losing weight. Surprisingly, there was a reduction in strategies both to lose weight and increase muscles as children approached adolescence. The implications of these findings for preventative educational programs for boys and girls are discussed.

A longitudinal study to explain stratiges to change weight and muscles among normal weight and overweight children

Previous research has indicated that both boys and girls strive for a slim body, with boys having an additional focus on a muscular body build. The current study was designed to evaluate the utility of a biopsychosocial model to explain body image and body change strategies among children. The study evaluated changes over time in body image and strategies to lose weight and increase muscles among 132 normal weight and 67 overweight boys (mean age=9.23 years) and 158 normal weight and 55 overweight girls (mean age=9.33 years). The predictive role of BMI, positive and negative affect, self-esteem and perceived sociocultural pressures to lose weight or increase muscle on body image and body change strategies over a 16 month period was evaluated. All participants completed the questionnaire on both occasions. The results demonstrated that both overweight boys and girls were more likely to be dissatisfied with their weight, place more importance on their weight, engage in more strategies to lose weight as well as perceive more pressure to lose weight. Overweight boys and girls were also more likely to report lower levels of self-esteem and positive affect, and higher levels of negative affect, and reported a reduction in their self-esteem over time. Regression analyses demonstrated that among overweight boys, low self-esteem and high levels of perceived pressure to lose weight predicted weight dissatisfaction; for overweight girls, weight dissatisfaction was also predicted by low levels of self-esteem. The implication of these findings in terms of factors contributing to the adoption of health risk behaviors among children is discussed.

Will he get back to normal? survival and functional status after intensive care therapy

The study aim was to address healthcare workers’ and patients’ questions about the likely level of recovery at 6 months of patients admitted to an Australian intensive care unit (ICU). Ninety-three consecutive, eligible adults were identified and followed prospectively. Severity of illness on admission was assessed using Acute Physiological and Chronic Health Evaluation (APACHE II), while functional status at 6 months was evaluated using the Sickness Impact Profile (SIP). Cumulative mortality was 25%. Admission severity of illness was associated with survival at 6 months (P≤0.001). Fifty-one (78%) of the 70 survivors were interviewed. Admission severity of illness scores correlated with functional status at 6 months (r=0.34, P=0.01), a finding reported in only one other study. More than half of those interviewed had returned to near pre-admission functional status. Those with poor functional status included high proportions of people with chronic illness and head injury. Overall, physical recovery was more complete than psychosocial recovery. The findings provide useful information for addressing questions relating to physical and psychosocial recovery, appetite, sleep patterns and return to work post discharge.