The relationship between hip abductor muscle strength and magnitude of pelvic drop following a 3 week strengthening protocol in non-specific low back pain patients.

Purpose: To examine the relationship between hip abductor muscle (HABD) strength and the magnitude of pelvic drop (MPD) for patients with non-specific low back pain (NSLBP) and controls (CON) prior to and following a 3-week HABD strengthening protocol. At baseline, we hypothesized that NSLBP patients would exhibit reduced HABD strength and greater MPD compared to CON. Following the protocol, we hypothesized that strength would increase and MPD would decrease. Relevance: The Trendelenburg test (TT) is a common clinical test used to examine the ability of the HABD to maintain horizontal pelvic position during single limb stance. However, no study has specifically tested this theory. Moreover, no study has investigated the relationship between HABD strength and pelvic motion during walking or tested whether increased HABD strength would reduce the MPD. Methods: Quasi-experimental with 3-week exercise intervention. Fifteen NSLBP patients (32.5yrs,range 21-51yrs; VAS baseline: 5.3cm) and 10 CON (29.5yrs,range 22-47yrs) were recruited. Isometric HABD strength was measured using a force dynamometer and the average of three maximal voluntary contractions were normalized to body mass (N/kg). Two-dimensional MPD (degrees) was measured using a 60 Hz camera and was derived from two retroreflective-markers placed on the posterior superior iliac spines. MPD was measured while performing the static TT and while walking and averaged over 10 consecutive footfalls. NSLBP patients completed a 3-week HABD strengthening protocol consisting of 2 open-kinetic-chain exercises then all measures were repeated. Non-parametric analysis was used for group comparisons and correlation analysis. Results: At baseline, the NSLBP patients demonstrated 31% reduced HABD strength (mean=6.6 N/kg) compared to CON (mean=9.5 N/kg: p=0.03) and no significant differences in maximal pelvic frontal plane excursion while walking (NSLBP:mean=8.1°, CON:mean=7.1°: p=0.72). No significant correlations were measured between left HABD strength and right MPD (r=-0.37, p=0.11), or between right HABD strength and left MPD (r=-0.04, p=0.84) while performing the static TT. Following the 3-week strengthening protocol, NSLBP patients demonstrated a 12% improvement in strength (Post:mean=7.4 N/kg: p=0.02), a reduction in pain (VAS followup: 2.8cm), but no significant decreases in MPD while walking (p=0.92). Conclusions: NSLBP patients demonstrated reduced HABD strength at baseline and were able to increase strength and reduce pain in a 3-week period. However, despite increases in HABD strength, the NSLBP group exhibited similar MPD motion during the static TT and while walking compared to baseline and controls. Implications: The results suggest that the HABD alone may not be primarily responsible for controlling a horizontal pelvic position during static and dynamic conditions. Increasing the strength of the hip abductors resulted in a reduction of pain in NSLBP patients providing evidence for further research to identify specific musculature responsible for controlling pelvic motion.

Cold-formed steel columns subject to local buckling at elevated temperatures

Fire safety design of building structures has received greater attention in recent times due to continuing losses of properties and lives in fires. However, the structural behaviour of thin-walled cold-formed steel columns under fire conditions is not well understood despite the increasing use of light gauge steels in building construction. Cold-formed steel columns are often subject to local buckling effects. Therefore a series of laboratory tests of lipped and unlipped channel columns made of varying steel thicknesses and grades was undertaken at uniform elevated temperatures up to 700°C under steady state conditions. Finite element models of the tested columns were also developed, and their elastic buckling and nonlinear analysis results were compared with test results at elevated temperatures. Effects of the degradation of mechanical properties of steel with temperature were included in the finite element analyses. The use of accurately measured yield stress, elasticity modulus and stress-strain curves at elevated temperatures provided a good comparison of the ultimate loads and load-deflection curves from tests and finite element analyses. The commonly used effective width design rules and the direct strength method at ambient temperature were then used to predict the ultimate loads at elevated temperatures by using the reduced mechanical properties. By comparing these predicted ultimate loads with those from tests and finite element analyses, the accuracy of using this design approach was evaluated.

Improved design rules for fixed ended cold-formed steel columns subject to flexural-torsional buckling

This paper has presented the details of an investigation into the flexural and flexuraltorsional buckling behaviour of cold-formed structural steel columns with pinned and fixed ends. Current design rules for the member capacities of cold-formed steel columns are based on the same non-dimensional strength curve for both fixed and pinned-ended columns. This research has reviewed the accuracy of the current design rules in AS/NZS 4600 and the North American Specification in determining the member capacities of cold-formed steel columns using the results from detailed finite element analyses and an experimental study of lipped channel columns. It was found that the current Australian and American design rules accurately predicted the member capacities of pin ended lipped channel columns undergoing flexural and flexural torsional buckling. However, for fixed ended columns with warping fixity undergoing flexural-torsional buckling, it was found that the current design rules significantly underestimated the column capacities as they disregard the beneficial effect of warping fixity. This paper has therefore proposed improved design rules and verified their accuracy using finite element analysis and test results of cold-formed lipped channel columns made of three cross-sections and five different steel grades and thicknesses.

Daytime pattern of post-exercise protein intake affects whole-body protein turnover in resistance-trained males

Background The pattern of protein intake following exercise may impact whole-body protein turnover and net protein retention. We determined the effects of different protein feeding strategies on protein metabolism in resistance-trained young men. Methods: Participants were randomly assigned to ingest either 80g of whey protein as 8x10g every 1.5h (PULSE; n=8), 4x20g every 3h (intermediate, INT; n=7), or 2x40g every 6h (BOLUS; n=8) after an acute bout of bilateral knee extension exercise (4x10 repetitions at 80% maximal strength). Whole-body protein turnover (Q), synthesis (S), breakdown (B), and net balance (NB) were measured throughout 12h of recovery by a bolus ingestion of [ 15N]glycine with urinary [15N]ammonia enrichment as the collected end-product. Results PULSE Q rates were greater than BOLUS (?19%, P<0.05) with a trend towards being greater than INT (?9%, P=0.08). Rates of S were 32% and 19% greater and rates of B were 51% and 57% greater for PULSE as compared to INT and BOLUS, respectively (P<0.05), with no difference between INT and BOLUS. There were no statistical differences in NB between groups (P=0.23); however, magnitude-based inferential statistics revealed likely small (mean effect90%CI; 0.590.87) and moderate (0.800.91) increases in NB for PULSE and INT compared to BOLUS and possible small increase (0.421.00) for INT vs. PULSE. Conclusion We conclude that the pattern of ingested protein, and not only the total daily amount, can impact whole-body protein metabolism. Individuals aiming to maximize NB would likely benefit from repeated ingestion of moderate amounts of protein (?20g) at regular intervals (?3h) throughout the day.

A pre-post evaluation of an ambulatory nutrition support service for malnourished patients post hospital discharge: a pilot study

Introduction Malnutrition is common among hospitalised patients, with poor follow-up of nutrition support post-discharge. Published studies on the efficacy of ambulatory nutrition support (ANS) for malnourished patients post-discharge are scarce. The aims of this study were to evaluate the rate of dietetics follow-up of malnourished patients post-discharge, before (2008) and after (2010) implementation of a new ANS service, and to evaluate nutritional outcomes post-implementation. Materials and Methods Consecutive samples of 261 (2008) and 163 (2010) adult inpatients referred to dietetics and assessed as malnourished using Subjective Global Assessment (SGA) were enrolled. All subjects received inpatient nutrition intervention and dietetic outpatient clinic follow-up appointments. For the 2010 cohort, ANS was initiated to provide telephone follow-up and home visits for patients who failed to attend the outpatient clinic. Subjective Global Assessment, body weight, quality of life (EQ-5D VAS) and handgrip strength were measured at baseline and five months post-discharge. Paired t-test was used to compare pre- and post-intervention results. Results In 2008, only 15% of patients returned for follow-up with a dietitian within four months post-discharge. After implementation of ANS in 2010, the follow-up rate was 100%. Mean weight improved from 44.0 ± 8.5kg to 46.3 ± 9.6kg, EQ-5D VAS from 61.2 ± 19.8 to 71.6 ± 17.4 and handgrip strength from 15.1 ± 7.1 kg force to 17.5 ± 8.5 kg force; p<0.001 for all. Seventy-four percent of patients improved in SGA score. Conclusion Ambulatory nutrition support resulted in significant improvements in follow-up rate, nutritional status and quality of life of malnourished patients post-discharge.

Buckling experiments on hollow flange beams with web stiffeners

A new cold-formed and resistance welded section known as the Hollow Flange Beam (HFB) has been developed recently in Australia. In contrast to the common lateral torsional buckling mode of I-beams, this unique section comprising two stiff triangular flanges and a slender web is susceptible to a lateral distortional buckling mode of failure involving lateral deflection, twist and cross-section change due to web distortion. This lateral distortional buckling behaviour has been shown to cause significant reduction of the available flexural strength of HFBs. An investigation using finite element analyses and large scale experiments was carried out into the use of transverse web plate stiffeners to improve the lateral buckling capacity of HFBs. This paper presents the details of the experimental investigation, the results, and the final stiffener arrangement whereas the details of the finite element analyses are presented in a companion paper at this conference.

Buckling experiments on hollow flange beams with web stiffeners

The hollow flange beam (HFB) is a new cold-formed and resistance-welded section developed in Australia. Due to its unique geometry comprising two stiff triangular flanges and a slender web, the HFB is susceptible to a lateral-distortional buckling mode of failure involving web distortion. Investigation using finite-element analyses showed that the use of transverse web plate stiffeners effectively eliminated lateral-distortional buckling of HFBs and thus any associated reduction in flexural capacity. A detailed experimental investigation was then carried out to validate the results from the finite-element analysis and to improve the stiffener configuration further. This led to the development of a special stiffener that is screw-fastened to the flanges on alternate sides of the web. This paper presents the details of the experimental investigations, the results, and the final stiffener arrangement whereas the details of the finite-element analyses are presented in a companion paper.

Local buckling behaviour of steel plate elements supported by a plastic foam material

Sandwich panels comprising steel facings and a polystyrene foam core are increasingly used as roof and wall claddings in buildings in Australia. When they are subjected to loads causing bending and/or axial compression, the steel plate elements of their profiled facing are susceptible to local buckling. However, when compared to panels with no foam core, they demonstrate significantly improved local buckling behaviour because they are supported by foam. In order to quantify such improvements and to validate the use of available design buckling stress formulae, an investigation using finite element analyses and laboratory experiments was carried out on steel plates that are commonly used in Australia of varying yield stress and thickness supported by a polystyrene foam core. This paper presents the details of this investigation, the buckling results and their comparison with available design buckling formulae.

Evaluation of an ambulatory nutrition support service for malnourished patients post hospital discharge

Introduction Malnutrition is common among hospitalised patients, with poor follow-up of nutrition support post-discharge. Published studies on the efficacy of ambulatory nutrition support (ANS) for malnourished patients post-discharge are scarce. The aims of this study were to evaluate the rate of dietetics follow-up of malnourished patients post-discharge, before (2008) and after (2010) implementation of a new ANS service, and to evaluate nutritional outcomes post-implementation. Materials and Methods Consecutive samples of 261 (2008) and 163 (2010) adult inpatients referred to dietetics and assessed as malnourished using Subjective Global Assessment (SGA) were enrolled. All subjects received inpatient nutrition intervention and dietetic outpatient clinic follow-up appointments. For the 2010 cohort, ANS was initiated to provide telephone follow-up and home visits for patients who failed to attend the outpatient clinic. Subjective Global Assessment, body weight, quality of life (EQ-5D VAS) and handgrip strength were measured at baseline and five months post-discharge. Paired t-test was used to compare pre- and post-intervention results. Results In 2008, only 15% of patients returned for follow-up with a dietitian within four months post-discharge. After implementation of ANS in 2010, the follow-up rate was 100%. Mean weight improved from 44.0 ± 8.5kg to 46.3 ± 9.6kg, EQ-5D VAS from 61.2 ± 19.8 to 71.6 ± 17.4 and handgrip strength from 15.1 ± 7.1 kg force to 17.5 ± 8.5 kg force; p<0.001 for all. Seventy-four percent of patients improved in SGA score. Conclusion Ambulatory nutrition support resulted in significant improvements in follow-up rate, nutritional status and quality of life of malnourished patients post-discharge.

Experimental investigation of post-fire mechanical properties of cold-formed steels

Cold-formed steel members are widely used in residential, industrial and commercial buildings as primary load-bearing elements. During fire events, they will be exposed to elevated temperatures. If the general appearance of the structure is satisfactory after a fire event then the question that has to be answered is how the load bearing capacity of cold-formed steel members in these buildings has been affected. Hence after such fire events there is a need to evaluate the residual strength of these members. However, the post-fire behaviour of cold-formed steel members has not been investigated in the past. This means conservative decisions are likely to be made in relation to fire exposed cold-formed steel buildings. Therefore an experimental study was undertaken to investigate the post-fire mechanical properties of cold-formed steels. Tensile coupons taken from cold-formed steel sheets of three different steel grades and thicknesses were exposed to different elevated temperatures up to 800 oC, and were then allowed to cool down to ambient temperature before they were tested to failure. Tensile coupon tests were conducted to obtain their post-fire stress-strain curves and associated mechanical properties (yield stress, Young’s modulus, ultimate strength and ductility). It was found that the post-fire mechanical properties of cold-formed steels are reduced below the original ambient temperature mechanical properties if they had been exposed to temperatures exceeding 300 oC. Hence a new set of equations is proposed to predict the post-fire mechanical properties of cold-formed steels. Such post-fire mechanical property assessments allow structural and fire engineers to make an accurate prediction of the safety of fire exposed cold-formed steel buildings. This paper presents the details of this experimental study and the results of post-fire mechanical properties of cold-formed steels. It also includes the results of a post-fire evaluation of cold-formed steel walls.

Flexural–torsional buckling behaviour and design of cold-formed steel compression members at elevated temperatures

Current design rules for the member capacities of cold-formed steel columns are based on the same non-dimensional strength curve for both fixed and pinned-ended columns at ambient temperature. This research has investigated the accuracy of using current ambient temperature design rules in Australia/New Zealand (AS/NZS 4600), American (AISI S100) and European (Eurocode 3 Part 1.3) standards in determining the flexural–torsional buckling capacities of cold-formed steel columns at uniform elevated temperatures using appropriately reduced mechanical properties. It was found that these design rules accurately predicted the member capacities of pin ended lipped channel columns undergoing flexural torsional buckling at elevated temperatures. However, for fixed ended columns with warping fixity undergoing flexural–torsional buckling, the current design rules significantly underestimated the column capacities as they disregard the beneficial effect of warping fixity. This paper has therefore recommended the use of improved design rules developed for ambient temperature conditions to predict the axial compression capacities of fixed ended columns subject to flexural–torsional buckling at elevated temperatures within AS/NZS 4600 and AISI S100 design provisions. The accuracy of the proposed fire design rules was verified using finite element analysis and test results of cold-formed lipped channel columns at elevated temperatures except for low strength steel columns with intermediate slenderness whose behaviour was influenced by the increased nonlinearity in the stress–strain curves at elevated temperatures. Further research is required to include these effects within AS/NZS 4600 and AISI S100 design rules. However, Eurocode 3 Part 1.3 design rules can be used for this purpose by using suitable buckling curves as recommended in this paper.

Local buckling studies of cold-formed steel compression members at elevated temperatures

Cold-formed steel members have been widely used in residential and commercial buildings as primary load bearing structural elements. They are often made of thin steel sheets and hence they are more susceptible to local buckling. The buckling behaviour of cold-formed steel compression members under fire conditions is not fully investigated yet and hence there is a lack of knowledge on the fire performance of cold-formed steel compression members. Current cold-formed steel design standards do not provide adequate design guidelines for the fire design of cold-formed steel compression members. Therefore a research project based on extensive experimental and numerical studies was undertaken to investigate the local buckling behaviour of light gauge cold-formed steel compression members under simulated fire conditions. First a series of 91 local buckling tests was conducted at ambient and uniform elevated temperatures up to 700oC on cold-formed lipped and unlipped channels. Suitable finite element models were then developed to simulate the behaviour of tested columns and were validated using test results. All the ultimate load capacity results for local buckling were compared with the predictions from the available design rules based on AS/NZS 4600, BS 5950 Part 5, Eurocode 3 Parts 1.2 and 1.3 and the direct strength method (DSM), based on which suitable recommendations have been made for the fire design of cold-formed steel compression members subject to local buckling at uniform elevated temperatures.

Effects of resistance training on measures of muscular strength in people with Parkinson’s disease: A systematic review and meta-analysis

Objective The aim of this systematic review and meta-analysis was to determine the overall effect of resistance training (RT) on measures of muscular strength in people with Parkinson’s disease (PD). Methods Controlled trials with parallel-group-design were identified from computerized literature searching and citation tracking performed until August 2014. Two reviewers independently screened for eligibility and assessed the quality of the studies using the Cochrane risk-of-bias-tool. For each study, mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for continuous outcomes based on between-group comparisons using post-intervention data. Subgroup analysis was conducted based on differences in study design. Results Nine studies met the inclusion criteria; all had a moderate to high risk of bias. Pooled data showed that knee extension, knee flexion and leg press strength were significantly greater in PD patients who undertook RT compared to control groups with or without interventions. Subgroups were: RT vs. control-without-intervention, RT vs. control-with-intervention, RT-with-other-form-of-exercise vs. control-without-intervention, RT-with-other-form-of-exercise vs. control-with-intervention. Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention. Compared to treadmill or balance exercise it resulted in greater knee flexion, but not knee extension or leg press strength. RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention. Discussion Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise. However, depending on muscle group and/or training dose, RT may not be superior to other exercise types. Interventions which combine RT with other exercise may be most effective. Findings should be interpreted with caution due to the relatively high risk of bias of most studies.

Effects of cold water immersion and active recovery on hemodynamics and recovery of muscle strength following resistance exercise

Cold water immersion (CWI) and active recovery (ACT) are frequently used as post-exercise recovery strategies. However, the physiological effects of CWI and ACT after resistance exercise are not well characterized. We examined the effects of CWI and ACT on cardiac output (Q), muscle oxygenation (SmO2) and blood volume (tHb), muscle temperature (Tmuscle ) and isometric strength after resistance exercise. On separate days, 10 men performed resistance exercise, followed by 10 min CWI at 10°C or 10 min ACT (low-intensity cycling). Q (7.9±2.7 l) and Tmuscle (2.2±0.8ºC) increased, whereas SmO2 (-21.5±8.8%) and tHb (-10.1±7.7 μM) decreased after exercise (p<0.05). During CWI, Q ̇(-1.1±0.7 l) and Tmuscle (-6.6±5.3ºC) decreased, while tHb (121±77 μM) increased (p<0.05). In the hour after CWI, Q ̇and Tmuscle remained low, while tHb also decreased (p<0.05). By contrast, during ACT, Q ̇(3.9±2.3 l), Tmuscle (2.2±0.5ºC), SmO2 (17.1±5.7%) and tHb (91±66 μM) all increased (p<0.05). In the hour after ACT, Tmuscle and tHb remained high (p<0.05). Peak isometric strength during 10 s maximum voluntary contractions (MVCs) did not change significantly after CWI, whereas it decreased after ACT (-30 to -45 Nm; p<0.05). Muscle deoxygenation time during MVCs increased after ACT (p<0.05), but not after CWI. Muscle reoxygenation time after MVCs tended to increase after CWI (p=0.052). These findings suggest firstly that hemodynamics and muscle temperature after resistance exercise are dependent on ambient temperature and metabolic demands with skeletal muscle, and secondly, that recovery of strength after resistance exercise is independent of changes in hemodynamics and muscle temperature.

Nonlinear analysis for the pre- and post-yield behaviour of a hybrid structure by a higher-order element with the refined plastic hinge approach

Efficient and accurate geometric and material nonlinear analysis of the structures under ultimate loads is a backbone to the success of integrated analysis and design, performance-based design approach and progressive collapse analysis. This paper presents the advanced computational technique of a higher-order element formulation with the refined plastic hinge approach which can evaluate the concrete and steel-concrete structure prone to the nonlinear material effects (i.e. gradual yielding, full plasticity, strain-hardening effect when subjected to the interaction between axial and bending actions, and load redistribution) as well as the nonlinear geometric effects (i.e. second-order P-d effect and P-D effect, its associate strength and stiffness degradation). Further, this paper also presents the cross-section analysis useful to formulate the refined plastic hinge approach.