Postural control in elderly women with osteoporosis: comparison of balance, strengthening and stretching exercises. A randomized controlled trial

Objective: To compare the efficacy of balance training associated with muscle strengthening or stretching, relative to no intervention, in the postural control of elderly women with osteoporosis. Design: A randomized, controlled trial. Subjects and interventions: Sample consisted of 50 women aged 65 years or older, with osteoporosis, randomized into one of three groups: strengthening group (n = 17) performed balance training with muscle strengthening; stretching group (n = 17) performed balance training with stretching; and control group (n = 16), no activities. Interventions lasted eight weeks, twice a week, 60 minutes a day. Main measures: Postural control was evaluated by the modified Clinical Test of Sensory Interaction for Balance (CTSIBm) and Limits of Stability Test. Strength was assessed by dynamometry and the shortening of the hamstrings by goniometry. Results: Relative to controls, participants in the strengthening group displayed significantly increased dorsiflexion strength and knee flexion strength, as well as centre of pressure velocity, directional control, and oscillation velocity (CTSIBm test). The stretching group had significantly improvements in hamstring length, knee flexion strength, centre of pressure velocity, and amplitude of movements. Relative to the stretching group, the strengthening group yielded better knee extension strength and directional control. Conclusion: The results suggest that both interventions are effective in improving postural control when compared to the control group, and the strengthening group was superior to the stretching group in knee extension strength and in directional control.

Effects of a combined strengthening, stretching and functional training program versus usual-care on gait biomechanics and foot function for diabetic neuropathy: a randomized controlled trial

Background: Polyneuropathy is a complication of diabetes mellitus that has been very challenging for clinicians. It results in high public health costs and has a huge impact on patients' quality of life. Preventive interventions are still the most important approach to avoid plantar ulceration and amputation, which is the most devastating endpoint of the disease. Some therapeutic interventions improve gait quality, confidence, and quality of life; however, there is no evidence yet of an effective physical therapy treatment for recovering musculoskeletal function and foot rollover during gait that could potentially redistribute plantar pressure and reduce the risk of ulcer formation. Methods/Design: A randomised, controlled trial, with blind assessment, was designed to study the effect of a physiotherapy intervention on foot rollover during gait, range of motion, muscle strength and function of the foot and ankle, and balance confidence. The main outcome is plantar pressure during foot rollover, and the secondary outcomes are kinetic and kinematic parameters of gait, neuropathy signs and symptoms, foot and ankle range of motion and function, muscle strength, and balance confidence. The intervention is carried out for 12 weeks, twice a week, for 40-60 min each session. The follow-up period is 24 weeks from the baseline condition. Discussion: Herein, we present a more comprehensive and specific physiotherapy approach for foot and ankle function, by choosing simple tasks, focusing on recovering range of motion, strength, and functionality of the joints most impaired by diabetic polyneuropathy. In addition, this intervention aims to transfer these peripheral gains to the functional and more complex task of foot rollover during gait, in order to reduce risk of ulceration. If it shows any benefit, this protocol can be used in clinical practice and can be indicated as complementary treatment for this disease.

EFFECTS OF MUSCULAR STRETCHING AND SEGMENTAL STABILIZATION ON FUNCTIONAL DISABILITY AND PAIN IN PATIENTS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED, CONTROLLED TRIAL

Objective: The purpose of this study was to compare the effects of 2 exercise programs, segmental stabilization exercises (SSEs) and stretching of trunk and hamstrings muscles, on functional disability, pain, and activation of the transversus abdominis muscle (TrA), in individuals with chronic low back pain. Methods: A total of 30 participants were enrolled in this study and randomly assigned to 1 of 2 groups as a function of intervention. In the segmental stabilization group (SS), exercises focused on the TrA and lumbar multifidus muscles, whereas in the stretching group (ST), exercises focused on stretching the erector spinae, hamstrings, and triceps surae. Severity of pain (visual analog scale and McGill pain questionnaire) and functional disability (Oswestry disability questionnaire) and TrA muscle activation capacity (Pressure Biofeedback Unit, or PBU) were compared as a function of intervention. Interventions lasted 6 weeks, and sessions happened twice a week (30 minutes each). Analysis of variance was used for intergroup and intragroup comparisons. Results: As compared with baseline, both treatments were effective in relieving pain and improving disability (P < .001). Those in the SS group had significantly higher gains for all variables. The stretching group did not effectively activate the TrA (P = .94). Conclusion: Both techniques improved pain and reduced disability. In this study, SS was superior to muscular stretching for the measured variables associated with chronic low back pain. (J Manipulative Physiol Ther 2012;35:279-285)

Upper crustal earthquake swarms in São Caetano: reactivation of the Pernambuco shear zone and trending branches in intraplate Brazil

Seismogenic fault reactivation of continental-scale structures has been observed in a few intraplate areas, but its cause is still amatter of debate. The objective of the present study is to analyze two seismic swarms that occurred along the EW-trending Pernambuco ductile shear zone and in a NE-trending branch, in 2007 and 2010 in São Caetano County, Northeastern Brazil.We studied both epicentral areas using a nine- and a seven-station network during 180 and 54 days, respectively. The results indicate that the 2007 swarm correspond to a right-lateral, strike–slip fault with a normal component of slip (strike 74°, dip 60°, and rake−145°) and the 2010 swarmcorresponds to a normal fault (strike 265°, dip 79°, and rake −91°). The former reactivated a NE-trending branch, whereas the latter reactivated the main E-W-trending mylonitic belt of the Pernambuco shear zone. These results are consistent with seismogenic reactivation of this major structure, generated by the present-day EW-trending compression and NS-trending extension, as observed by previous studies. This shear zone was reactivated as rift faults in the Cretaceous during the South America–Africa breakup. However, our study confirms that the basement fabric such as continental-scale ductile shear zones, show evidence of crustal weakness outside areas of previous rifting, and it reveals the potential for large earthquakes along dormant rift segments associated with major basement shear belts.

Estimating crustal deformation from geodetic data

By the end of the 19th century, geodesy has contributed greatly to the knowledge of regional tectonics and fault movement through its ability to measure, at sub-centimetre precision, the relative positions of points on the Earth’s surface. Nowadays the systematic analysis of geodetic measurements in active deformation regions represents therefore one of the most important tool in the study of crustal deformation over different temporal scales [e.g., Dixon, 1991]. This dissertation focuses on motion that can be observed geodetically with classical terrestrial position measurements, particularly triangulation and leveling observations. The work is divided into two sections: an overview of the principal methods for estimating longterm accumulation of elastic strain from terrestrial observations, and an overview of the principal methods for rigorously inverting surface coseismic deformation fields for source geometry with tests on synthetic deformation data sets and applications in two different tectonically active regions of the Italian peninsula. For the long-term accumulation of elastic strain analysis, triangulation data were available from a geodetic network across the Messina Straits area (southern Italy) for the period 1971 – 2004. From resulting angle changes, the shear strain rates as well as the orientation of the principal axes of the strain rate tensor were estimated. The computed average annual shear strain rates for the time period between 1971 and 2004 are γ˙1 = 113.89 ± 54.96 nanostrain/yr and γ˙2 = -23.38 ± 48.71 nanostrain/yr, with the orientation of the most extensional strain (θ) at N140.80° ± 19.55°E. These results suggests that the first-order strain field of the area is dominated by extension in the direction perpendicular to the trend of the Straits, sustaining the hypothesis that the Messina Straits could represents an area of active concentrated deformation. The orientation of θ agree well with GPS deformation estimates, calculated over shorter time interval, and is consistent with previous preliminary GPS estimates [D’Agostino and Selvaggi, 2004; Serpelloni et al., 2005] and is also similar to the direction of the 1908 (MW 7.1) earthquake slip vector [e.g., Boschi et al., 1989; Valensise and Pantosti, 1992; Pino et al., 2000; Amoruso et al., 2002]. Thus, the measured strain rate can be attributed to an active extension across the Messina Straits, corresponding to a relative extension rate ranges between < 1mm/yr and up to ~ 2 mm/yr, within the portion of the Straits covered by the triangulation network. These results are consistent with the hypothesis that the Messina Straits is an important active geological boundary between the Sicilian and the Calabrian domains and support previous preliminary GPS-based estimates of strain rates across the Straits, which show that the active deformation is distributed along a greater area. Finally, the preliminary dislocation modelling has shown that, although the current geodetic measurements do not resolve the geometry of the dislocation models, they solve well the rate of interseismic strain accumulation across the Messina Straits and give useful information about the locking the depth of the shear zone. Geodetic data, triangulation and leveling measurements of the 1976 Friuli (NE Italy) earthquake, were available for the inversion of coseismic source parameters. From observed angle and elevation changes, the source parameters of the seismic sequence were estimated in a join inversion using an algorithm called “simulated annealing”. The computed optimal uniform–slip elastic dislocation model consists of a 30° north-dipping shallow (depth 1.30 ± 0.75 km) fault plane with azimuth of 273° and accommodating reverse dextral slip of about 1.8 m. The hypocentral location and inferred fault plane of the main event are then consistent with the activation of Periadriatic overthrusts or other related thrust faults as the Gemona- Kobarid thrust. Then, the geodetic data set exclude the source solution of Aoudia et al. [2000], Peruzza et al. [2002] and Poli et al. [2002] that considers the Susans-Tricesimo thrust as the May 6 event. The best-fit source model is then more consistent with the solution of Pondrelli et al. [2001], which proposed the activation of other thrusts located more to the North of the Susans-Tricesimo thrust, probably on Periadriatic related thrust faults. The main characteristics of the leveling and triangulation data are then fit by the optimal single fault model, that is, these results are consistent with a first-order rupture process characterized by a progressive rupture of a single fault system. A single uniform-slip fault model seems to not reproduce some minor complexities of the observations, and some residual signals that are not modelled by the optimal single-fault plane solution, were observed. In fact, the single fault plane model does not reproduce some minor features of the leveling deformation field along the route 36 south of the main uplift peak, that is, a second fault seems to be necessary to reproduce these residual signals. By assuming movements along some mapped thrust located southward of the inferred optimal single-plane solution, the residual signal has been successfully modelled. In summary, the inversion results presented in this Thesis, are consistent with the activation of some Periadriatic related thrust for the main events of the sequence, and with a minor importance of the southward thrust systems of the middle Tagliamento plain.

Crustal heterogeneities and complexities of fault processes

In this work we study the relation between crustal heterogeneities and complexities in fault processes. The first kind of heterogeneity considered involves the concept of asperity. The presence of an asperity in the hypocentral region of the M = 6.5 earthquake of June 17-th, 2000 in the South Iceland Seismic Zone was invoked to explain the change of seismicity pattern before and after the mainshock: in particular, the spatial distribution of foreshock epicentres trends NW while the strike of the main fault is N 7◦ E and aftershocks trend accordingly; the foreshock depths were typically deeper than average aftershock depths. A model is devised which simulates the presence of an asperity in terms of a spherical inclusion, within a softer elastic medium in a transform domain with a deviatoric stress field imposed at remote distances (compressive NE − SW, tensile NW − SE). An isotropic compressive stress component is induced outside the asperity, in the direction of the compressive stress axis, and a tensile component in the direction of the tensile axis; as a consequence, fluid flow is inhibited in the compressive quadrants while it is favoured in tensile quadrants. Within the asperity the isotropic stress vanishes but the deviatoric stress increases substantially, without any significant change in the principal stress directions. Hydrofracture processes in the tensile quadrants and viscoelastic relaxation at depth may contribute to lower the effective rigidity of the medium surrounding the asperity. According to the present model, foreshocks may be interpreted as induced, close to the brittle-ductile transition, by high pressure fluids migrating upwards within the tensile quadrants; this process increases the deviatoric stress within the asperity which eventually fails, becoming the hypocenter of the mainshock, on the optimally oriented fault plane. In the second part of our work we study the complexities induced in fault processes by the layered structure of the crust. In the first model proposed we study the case in which fault bending takes place in a shallow layer. The problem can be addressed in terms of a deep vertical planar crack, interacting with a shallower inclined planar crack. An asymptotic study of the singular behaviour of the dislocation density at the interface reveals that the density distribution has an algebraic singularity at the interface of degree ω between -1 and 0, depending on the dip angle of the upper crack section and on the rigidity contrast between the two media. From the welded boundary condition at the interface between medium 1 and 2, a stress drop discontinuity condition is obtained which can be fulfilled if the stress drop in the upper medium is lower than required for a planar trough-going surface: as a corollary, a vertically dipping strike-slip fault at depth may cross the interface with a sedimentary layer, provided that the shallower section is suitably inclined (fault "refraction"); this results has important implications for our understanding of the complexity of the fault system in the SISZ; in particular, we may understand the observed offset of secondary surface fractures with respect to the strike direction of the seismic fault. The results of this model also suggest that further fractures can develop in the opposite quadrant and so a second model describing fault branching in the upper layer is proposed. As the previous model, this model can be applied only when the stress drop in the shallow layer is lower than the value prescribed for a vertical planar crack surface. Alternative solutions must be considered if the stress drop in the upper layer is higher than in the other layer, which may be the case when anelastic processes relax deviatoric stress in layer 2. In such a case one through-going crack cannot fulfil the welded boundary conditions and unwelding of the interface may take place. We have solved this problem within the theory of fracture mechanics, employing the boundary element method. The fault terminates against the interface in a T-shaped configuration, whose segments interact among each other: the lateral extent of the unwelded surface can be computed in terms of the main fault parameters and the stress field resulting in the shallower layer can be modelled. A wide stripe of high and nearly uniform shear stress develops above the unwelded surface, whose width is controlled by the lateral extension of unwelding. Secondary shear fractures may then open within this stripe, according to the Coulomb failure criterion, and the depth of open fractures opening in mixed mode may be computed and compared with the well studied fault complexities observed in the field. In absence of the T-shaped decollement structure, stress concentration above the seismic fault would be difficult to reconcile with observations, being much higher and narrower.

Recycled crustal material in the geochemical record of Pacific ocean island basalts from Pitcairn, Hawaii and Rurutu

Die Isotopenzusammensetzungen des Pitcairn Hotspot (Südpazifik), des Mauna Kea (Hawaii) und der Insel Rurutu (Französisch Polynesien) wurden bestimmt, um Heterogenitäten im Erdmantel zu charakterisieren. Die Bleiisotopenzusammensetzung wurde mit einer Dreiisotopenspiketechnik zur Korrektur der instrumentellen Massenfraktionierung gemessen. An Proben von Pitcairn wurde zusätzlich die Os, Hf, Nd, Sr Isotopenzusammensetzung, sowie die Haupt- und Spurenelementzusammensetzung bestimmt. Die Isotopensignatur des Pitcairn Hotspots kann durch eine Sedimentkomponente in der Magmenquelle erklärt werden. Die Bleiisotopenschwankungen des Mauna Kea in der HSDP-2 Bohrung treten als Oszillationen auf, die sich zu linearen Anordnungen im Bleiisotopenraum zusammensetzen. Das begrenzte zeitliche Auftreten einer linearen Anordnung zeigt, daß die Heterogenitäten mehrere zehner Kilometer Länge im aufsteigenden Mantelmaterial unter dem Vulkan einnehmen. Auch die Bleiisotopenzusammensetzungen der Rurutu-laven zeigen lineare Anordnungen.Diese lineare Anordnungen im Bleiisotopenraum können durch eine vorwiegend binäre Mischung erklärt werden. Ein Bleiisotopenentwicklungsmodell unterstützt, daß die Differenzierung der Ausgangsmaterialien vor weniger als etwa zwei Milliarden Jahren geschah und für Mauna Kea relativ jung sein könnte. Keine der Hotspots weisen identische Mischungsendglieder auf, so daß die Heterogenitäten kleinräumige Merkmale im Erdmantel sind.

Imaging of crustal scatterers using multiple seismic arrays

Array seismology is an useful tool to perform a detailed investigation of the Earth’s interior. Seismic arrays by using the coherence properties of the wavefield are able to extract directivity information and to increase the ratio of the coherent signal amplitude relative to the amplitude of incoherent noise. The Double Beam Method (DBM), developed by Krüger et al. (1993, 1996), is one of the possible applications to perform a refined seismic investigation of the crust and mantle by using seismic arrays. The DBM is based on a combination of source and receiver arrays leading to a further improvement of the signal-to-noise ratio by reducing the error in the location of coherent phases. Previous DBM works have been performed for mantle and core/mantle resolution (Krüger et al., 1993; Scherbaum et al., 1997; Krüger et al., 2001). An implementation of the DBM has been presented at 2D large-scale (Italian data-set for Mw=9.3, Sumatra earthquake) and at 3D crustal-scale as proposed by Rietbrock & Scherbaum (1999), by applying the revised version of Source Scanning Algorithm (SSA; Kao & Shan, 2004). In the 2D application, the rupture front propagation in time has been computed. In 3D application, the study area (20x20x33 km3), the data-set and the source-receiver configurations are related to the KTB-1994 seismic experiment (Jost et al., 1998). We used 60 short-period seismic stations (200-Hz sampling rate, 1-Hz sensors) arranged in 9 small arrays deployed in 2 concentric rings about 1 km (A-arrays) and 5 km (B-array) radius. The coherence values of the scattering points have been computed in the crustal volume, for a finite time-window along all array stations given the hypothesized origin time and source location. The resulting images can be seen as a (relative) joint log-likelihood of any point in the subsurface that have contributed to the full set of observed seismograms.

Lattice preferred orientation in omphacite: Examples from the Tauern Window, Austria and the Western Gneiss Region, Norway

It is lively debated how eclogites find their way from deep to mid-crustal levels during exhumation. Different exhumation models for high-pressure and ultrahigh-pressure rocks were suggested in previous studies, based mainly on field observations and less on microstructural studies on the exhumed rocks. The development and improvement of electron microscopy techniques allows it, to focus interest on direct investigations of microstructures and crystallographic properties in eclogites. In this case, it is of importance to study the applicability of crystallographic measurements on eclogites for exhumation processes and to unravel which processes affect eclogite textures. Previous studies suggested a strong relationship between deformation and lattice preferred orientation (LPO) in omphacite but it is still unclear if the deformation is related to the exhumation of eclogites. This study is focused on the questions which processes affect omphacite LPO and if textural investigations of omphacite are applicable for studying eclogite exhumation. Therefore, eclogites from two examples in the Alps and in the Caledonides were collected systematically and investigated with respect to omphacite LPO by using the electron backscattered diffraction (EBSD) technique. Omphacite textures of the Tauern Window (Austria) and the Western Gneiss Region (Norway) were studied to compare lattice preferred orientation with field observations and suggested exhumation models from previous studies. The interpretation of omphacite textures, regarding the deformation regime is mainly based on numerical simulations in previous studies. Omphacite LPO patterns of the Eclogite Zone are clearly independent from any kind of exhumation process. The textures were generated during omphacite growth on the prograde path of eclogite development until metamorphic peak conditions. Field observations in the Eclogite Zone show that kinematics in garnet mica schist, surrounding the eclogites, strongly indicate an extrusion wedge geometry. Stretching lineations show top-N thrusting at the base and a top-S normal faulting with a sinistral shear component at the top of the Eclogite Zone. The different shear sense on both sides of the unit does not affect the omphacite textures in any way. The omphacite lattice preferred orientation patterns of the Western Gneiss Region can not be connected with any exhumation model. The textures were probably generated during the metamorphic peak and reflect the change from subduction to exhumation. Eclogite Zone and Western Gneiss Region differ significantly in size and especially in metamorphic conditions. While the Eclogite Zone is characterized by constant P-T conditions (600-650°C, 20-25 kbar), the Western Gneiss Region contains a wide P-T range from high- to ultrahigh pressure conditions (400-800°C, 20-35 kbar). In contrast to this, the omphacite textures of both units are very similar. This means that omphacite LPO is independent from P-T conditions and therefore from burial depth. Further, in both units, omphacite LPO is independent from grain and subgrain size as well as from any shape preferred orientation (SPO) on grain and subgrain scale. Overall, omphacite lattice preferred orientation are generated on the prograde part of omphacite development. Therefore, textural investigations on omphacite LPO are not applicable to study eclogite exhumation.

Induction of p38, tumour necrosis factor-α and RANTES by mechanical stretching of keratinocytes expressing mutant keratin 10R156H

Epidermolytic hyperkeratosis (bullous congenital ichthyosiform erythroderma), characterized by ichthyotic, rippled hyperkeratosis, erythroderma and skin blistering, is a rare autosomal dominant disease caused by mutations in keratin 1 or keratin 10 (K10) genes. A severe phenotype is caused by a missense mutation in a highly conserved arginine residue at position 156 (R156) in K10.