Does inspiration efficiency influence the stability limits of the trunk in patients with chronic low back pain?

OBJECTIVE: To determine the effects of diaphragm-strengthening training on the stability limits of the trunk and inspiratory function in patients with low back pain. DESIGN: A randomized comparative trial including a diaphragm training group that took part in conventional training together with diaphragm strengthening, and a control group that took part in conventional training only. Both groups participated in an 8-week training, 2 times/week. All subjects underwent the same measurement protocol before and after the intervention. PATIENTS: The study included 52 subjects with chronic low back pain. METHODS: The inspiratory functions (chest excursion, maximal inspiratory pressure, peak inspiratory flow, and volume of inspired air) and stability limits of the trunk with the subject in the sitting position (modified functional and lateral reach test) were assessed. RESULTS: Maximal inspiratory pressure and stability limit tests showed a statistically significant improvement only in the diaphragm training group. Statistically significant improvements in chest excursion and peak expiratory flow tests were found in both groups; however, the improvement was more greater in the diaphragm training group. CONCLUSION: Conventional exercises together with diaphragm training result in a greater improvement than conventional exercises alone in patients with chronic low back pain.

In vivo calcium and phosphate iontophoresis for the topical treatment of osteoporosis.

BACKGROUND: In addition to systemic treatment, osteoporosis may be treated topically by incorporating calcium and phosphate into the bone. OBJECTIVE: This article describes the use of a recently developed, novel iontophoretic apparatus suitable for local ion delivery into bones. In this study, in vivo experiments were performed to compare the effects of local electrotherapy and those of systemic hormone replacement on bone. DESIGN: In this study, local iontophoresis was carried out in ovariectomized and control rats. Bone density, biomechanical, and elemental studies were performed. METHODS: Forty 12-week-old Sprague-Dawley rats received an ovariectomy (OVX) or were sham-operated (sham). Twenty-one weeks later, tibias of subgroups of sham-operated and OVX animals were subjected to serial local iontophoresis (IOP) treatments, received systemic subcutaneous 17ß-estradiol (E2), or were treated with the combination of IOP and E2. Changes in bone density were detected by quantitative ultrasound densitometry and expressed as amplitude-dependent speed of sound (AD-SoS). Biomechanical studies and elemental analysis were performed at the end of the experiments. RESULTS: Osteopenia developed 21 weeks after OVX in the proximal tibial regions; the mean difference estimate (95% confidence intervals) of AD-SoS values between the sham-operated and OVX animals was 188.7 (140.4-237.1). Serial iontophoretic treatment resulted in an increase in bone density in both sham-operated and OVX animals (sham+IOP versus sham: 121.4 [73.01-169.7]; OVX+IOP versus OVX: 241.6 [193.2-289.9]). Similar changes in AD-SoS were detected after 17ß-estradiol (E2) treatment; however, even greater changes occurred after OVX+E2+IOP versus OVX+E2 (123.4 [75.1-171.8]). Similar improvements also were evident regarding the biomechanical features of the tibias. LIMITATIONS: A limitation of this study was the relatively small number of rats. CONCLUSIONS: The efficacy of local IOP using calcium- and phosphate-donating microparticles is comparable to that of estrogen therapy as evidenced by steadily increasing bone density, restoration of the calcium and phosphate balance, and improvement in the biomechanical properties of the bone.

Two subgroups of schizophrenia identified by systematic cognitive neuropsychiatric mapping.

The description of the heterogeneous phenomenological, pathophysiological, and etiological nature of schizophrenia is under way; however, the relationships between heterogeneity levels are still unclear. We performed a robust cross-sectional study, including a systematic neuropsychological battery, assessment of clinical symptoms, neurological soft signs, morphogenetic anomalies and smell identification, and measurement of event-related potentials on 50 outpatients with schizophrenia in their compensated states. An explorative fuzzy cluster analysis revealed two subgroups in this sample that could be distinguished from each other on symptomatological, cognitive and neurological levels. The patterns of cognitive dysfunctions and neurological developmental anomalies equally indicate that there may be hemispherical differences between the patients belonging to the different clusters.

Effects of a hypnotically altered state of consciousness on intensification of semantic processing.

In a study of the linguistic processes involved in hypnosis, 22 volunteer medical students performed semantic and phonologic fluency tasks and then associative priming tests with 2 delay-lengths in waking alert and hypnotic conditions as well. The participants performed better during semantic than phonological fluency tests in alert and also in hypnotic states, and this difference was significantly greater in hypnosis. The increased semantic performance in hypnosis was accompanied by a decrease of the rule-offending errors. Significant semantic priming effects were detected in both states of consciousness in direct and indirect relations as well as in the automatic, intralexical level, and also when the extralexical control processes were activated. Overall, the results appear to show that the hypnotically altered state of consciousness produces significantly better performance in semantic information processing than can be elicited in alert waking conditions.