Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial

Objective: To compare an accelerated intervention incorporating early therapeutic exercise after acute ankle sprains with a standard protection, rest, ice, compression, and elevation intervention.

Design: Randomised controlled trial with blinded outcome assessor.

Setting: Accident and emergency department and university based sports injury clinic.

Participants: 101 patients with an acute grade 1 or 2 ankle sprain.

Interventions: Participants were randomised to an accelerated intervention with early therapeutic exercise (exercise group) or a standard protection, rest, ice, compression, and elevation intervention (standard group).

Main outcome measures: The primary outcome was subjective ankle function (lower extremity functional scale). Secondary outcomes were pain at rest and on activity, swelling, and physical activity at baseline and at one, two, three, and four weeks after injury. Ankle function and rate of reinjury were assessed at 16 weeks.

Results: An overall treatment effect was in favour of the exercise group (P=0.0077); this was significant at both week 1 (baseline adjusted difference in treatment 5.28, 98.75% confidence interval 0.31 to 10.26; P=0.008) and week 2 (4.92, 0.27 to 9.57; P=0.0083). Activity level was significantly higher in the exercise group as measured by time spent walking (1.2 hours, 95% confidence interval 0.9 to 1.4 v 1.6, 1.3 to 1.9), step count (5621 steps, 95% confidence interval 4399 to 6843 v 7886, 6357 to 9416), and time spent in light intensity activity (53 minutes, 95% confidence interval 44 to 60 v 76, 58 to 95). The groups did not differ at any other time point for pain at rest, pain on activity, or swelling. The reinjury rate was 4% (two in each group).

Conclusion: An accelerated exercise protocol during the first week after ankle sprain improved ankle function; the group receiving this intervention was more active during that week than the group receiving standard care.

Early Holocene vegetation, human activity and climate from Sarawak, Malaysian Borneo

A 40mcore from Loagan Bunut,Malaysian Borneo, yielded a high-resolution early Holocene (11.3e6.75 ka) sequence of marginal-marine deposits. Palynological analysis showed relatively stable fire-regulated lowland forest through this time, with the local development and regression of mangrove vegetation. A general trend of rising rainfall and thus strengthening North East monsoonal circulation linked to the migration of the mean position of the ICTZ was interrupted by what may be episodes of drier climate and weakening monsoonal activity at 9250-8890, 7900 and 7600-7545 cal. BP. Magnetic susceptibility peaks suggestmarked short-term ENSO-style activity superimposed upon this record. Repeated markers for openand disturbed habitats, plus occasional imported and probably-cultivated taxa, point towards human impact from the earliest Holocene on the wet tropical forest at Loagan Bunut.

A 50,000-year record of Late Pleistocene tropical vegetation and human impact in lowland Borneo.

There has been considerable uncertainty about the nature of Pleistocene environments colonised by the first modern humans in Island SE Asia, and about the vegetation of the Last Glacial Maximum (LGM) in the region. Here, the palynology from a series of exposures in the Great Cave of Niah, Sarawak, Malaysian Borneo, spanning a period from ca. 52,000 to 5000 BP is described. Vegetation during this period was climate-driven and often highly unstable. Interstadials are marked by lowland forest, sometimes rather dry and at times by mangroves. Stadials are indicated by taxa characteristic of open environments or, as at the LGM, by highly disturbed rather open forest. Stadials are also characterised by taxa now restricted to 1000-1600 m above sea level, suggesting temperature declines of ca 7-9 C relative to present, by comparison with modern lapse rates. The practice of biomass burning appears associated with the earliest human activity in the cave.

THE IMPACT OF GRAZING ON COMMUNITIES OF GROUND-DWELLING SPIDERS (ARANEAE) IN UPLAND VEGETATION TYPES

Adult spider communities were sampled by pitfall trapping over a 24-month period in plots subjected to a range of grazing regimes on five vegetation types on a hill farm in County Antrim, north-east Ireland. Spider community composition was influenced by vegetation type and grazing regime. Variation in the number of individuals and species diversity was also apparent between vegetation types and grazing regime. Plots grazed by all herbivores were characterised by the predominance of species characteristic of disturbed land. Inbye land and areas where grazing had ceased had characteristic coloniser species. The spiders Erigone dentipalpis, Allomengea scopigera and Centromerita bicolor were trapped with greater success in vegetation types where grass species dominated.

Vegetation responses to rapid climatic changes during the last deglaciation 13,500-8,000 years ago on southwest Andoya, arctic Norway

The late-glacial vegetation development in northern Norway in response to climate changes during the Allerod, Younger Dryas (YD), and the transition to the Holocene is poorly known. Here we present a high-resolution record of floral and vegetation changes at lake Lusvatnet, south-west Andoya, between 13500 and 8000 cal b.p. Plant macrofossil and pollen analyses were done on the same sediment core and the proxy records follow each other very closely. The core has also been analyzed using an ITRAX XRF scanner in order to check the sediment sequence for disturbances or hiatuses. The core has a good radiocarbon-based chronology. The Saksunarvatn tephra fits very well chronostratigraphically. During both the Allerod and the Younger Dryas time-periods arctic vegetation prevailed, dominated by Salix polaris associated with many typically arctic herbs such as Saxifraga cespitosa, Saxifraga rivularis and Oxyria digyna. Both periods were cold and dry. Between 12450 and 12250 cal b.p. during the Younger Dryas chronozone, the assemblage changed, particularly in the increased abundance of Papaver sect. Scapiflora and other high-Arctic herbs, suggesting the development of polar desert vegetation mainly as a response to increased aridity. After 11520 cal b.p. a gradually warmer and more oceanic climate initiated a succession to dwarf-shrub vegetation and the establishment of Betula woodland after 1,000 years at c. 10520 cal b.p. The overall late-glacial aridity contrasts with oceanic conditions in southern Norway and is probably related to sea-ice extent.

Postglacial vegetation dynamics of western Tierra del Fuego

The southern fringes of the South American landmass provide a rare opportunity to examine the development of moorland vegetation with sparse tree cover in a wet, cool temperate climate of the Southern Hemisphere. We present a record of changes in vegetation over the past 17,000 years, from a lake in extreme southern Chile (Isla Santa Inés, Magallanes region, 53°38.97S; 72°25.24W), where human influence on vegetation is negligible. The western archipelago of Tierra del Fuego remained treeless for most of the Lateglacial period; Lycopodium magellanicum, Gunnera magellanica and heath species dominated the vegetation. Nothofagus may have survived the last glacial maximum at the eastern edge of the Magellan glaciers from where it spread southwestwards and established in the region at around 10,500 cal. yr BP. Nothofagus antarctica was likely the earlier colonizing tree in the western islands, followed shortly after by Nothofagus betuloides. At 9000 cal. yr BP moorland communities expanded at the expense of Nothofagus woodland. Simultaneously, Nothofagus species shifted to dominance of the evergreen Nothofagus betuloides and the Magellanic rain forest established in the region. Rapid and drastic vegetation changes occurred at 5200 cal. yr BP, after the Mt Burney MB2 eruption, including the expansion and establishment of Pilgerodendron uviferum and the development of mixed Nothofagus-Pilgerodendron-Drimys woodland. Scattered populations of Nothofagus, as they occur today in westernmost Tierra del Fuego may be a good analogue for Nothofagus populations during the Lateglacial in eastern sites.