Does Dynamic Tape change the walking biomechanics of women with greater trochanteric pain syndrome? A blinded randomised controlled crossover trial.

OBJECTIVES: There is considerable debate among clinicians as to whether sports tape can provide mechanical support and pain relief. People with greater trochanteric pain syndrome (GTPS) have increased adduction moment, adduction angle and pelvic obliquity, likely contributing to the continuation of the pathology. We aimed to see if Dynamic Tape® could control these movements and reduce pain. METHODS: Fifty women with GTPS participated in a three-dimensional gait analysis. Each participant performed three walking trials: baseline, and two subsequent trials, with active and sham applications of Dynamic Tape. The order of active and sham taping was randomised. Differences in kinetic and kinematic data were analysed using mixed model linear regressions for each condition. Pain scores were obtained before and immediately after walking trials. RESULTS: Hip adduction moment was reduced at first peak by both active (p < 0.001) and sham tape (p = 0.028), with no between group difference; at second peak by the active taping (p < 0.001), with a between-group difference (p < 0.001). Adduction angle was reduced at first peak by both active (p < 0.001) and sham taping (p = 0.026), with the active taping producing a larger effect (p = 0.004); at mid-stance by active taping (p = 0.003), with a between-group difference (p = 0.002); there was no reduction at second peak. Internal rotation was reduced at the first (p < 0.001) and second peaks (p < 0.001), and mid-stance by the active taping alone (p < 0.001). Pelvic obliquity was reduced at the first peak (p = 0.019), mid-stance (p < 0.001) and second peak (p < 0.001) by the active tape, with a between-group difference at mid-stance (p = 0.03). Both the active and sham taping resulted in a clinically meaningful pain reduction. CONCLUSION: Dynamic Tape produced a mechanical effect and a meaningful reduction in pain in women with GTPS. The extent that placebo or somatosensory input may have had on these results is not clear. CLINICAL TRIAL REGISTRATION NUMBER: ACTRN12617001611314.

Environmental and genetic factors influence the vitamin D content of cows' milk.

Vitamin D is obtained by cattle from the diet and from skin production via UVB exposure from sunlight. The vitamin D status of the cow impacts the vitamin D content of the milk produced, much like human breast milk, with seasonal variation in the vitamin D content of milk well documented. Factors such as changes in husbandry practices therefore have the potential to impact the vitamin D content of milk. For example, a shift to year-round housing from traditional practices of cattle being out to graze during the summer months and housed during the winter only, minimises exposure to the sun and has been shown to negatively influence the vitamin D content of the milk produced. Other practices such as changing dietary sources of vitamin D may also influence the vitamin D content of milk, and evidence exists to suggest genetic factors such as breed can cause variation in the concentrations of vitamin D in the milk produced. The present review aims to provide an overview of the current understanding of how genetic and environmental factors influence the vitamin D content of the milk produced by dairy cattle. A number of environmental and genetic factors have previously been identified as having influence on the nutritional content of the milk produced. The present review highlights a need for further research to fully elucidate how farmers could manipulate the factors identified to their advantage with respect to increasing the vitamin D content of milk and standardising it across the year.

Development and validation of a VISA tendinopathy questionnaire for greater trochanteric pain syndrome, the VISA-G.

BACKGROUND: Greater trochanteric pain syndrome (GTPS) is common, resulting in significant pain and disability. There is no condition specific outcome score to evaluate the degree of severity of disability associated with GTPS in patients with this condition. OBJECTIVE: To develop a reliable and valid outcome measurement capable of evaluating the severity of disability associated with GTPS. METHODS: A phenomenological framework using in-depth semi structured interviews of patients and medical experts, and focus groups of physiotherapists was used in the item generation. Item and format clarification was undertaken via piloting. Multivariate analysis provided the basis for item reduction. The resultant VISA-G was tested for reliability with the inter class co-efficient (ICC), internal consistency (Cronbach's Alpha), and construct validity (correlation co-efficient) on 52 naïve participants with GTPS and 31 asymptomatic participants. RESULTS: The resultant outcome measurement tool is consistent in style with existing tendinopathy outcome measurement tools, namely the suite of VISA scores. The VISA-G was found to be have a test-retest reliability of ICC2,1 (95% CI) of 0.827 (0.638-0.923). Internal consistency was high with a Cronbach's Alpha of 0.809. Construct validity was demonstrated: the VISA-G measures different constructs than tools previously used in assessing GTPS, the Harris Hip Score and the Oswestry Disability Index (Spearman Rho:0.020 and 0.0205 respectively). The VISA-G did not demonstrate any floor or ceiling effect in symptomatic participants. CONCLUSION: The VISA-G is a reliable and valid score for measuring the severity of disability associated GTPS.

Red meat from animals offered a grass diet increases plasma and platelet n-3 PUFA in healthy consumers.

Red meat from grass-fed animals, compared with concentrate-fed animals, contains increased concentrations of long-chain (LC) n-3 PUFA. However, the effects of red meat consumption from grass-fed animals on consumer blood concentrations of LC n-3 PUFA are unknown. The aim of the present study was to compare the effects on plasma and platelet LC n-3 PUFA status of consuming red meat produced from either grass-fed animals or concentrate-fed animals. A randomised, double-blinded, dietary intervention study was carried out for 4 weeks on healthy subjects who replaced their habitual red meat intake with three portions per week of red meat (beef and lamb) from animals offered a finishing diet of either grass or concentrate (n 20 consumers). Plasma and platelet fatty acid composition, dietary intake, blood pressure, and serum lipids and lipoproteins were analysed at baseline and post-intervention. Dietary intakes of total n-3 PUFA, as well as plasma and platelet concentrations of LC n-3 PUFA, were significantly higher in those subjects who consumed red meat from grass-fed animals compared with those who consumed red meat from concentrate-fed animals (P < 0·05). No significant differences in concentrations of serum cholesterol, TAG or blood pressure were observed between groups. Consuming red meat from grass-fed animals compared with concentrate-fed animals as part of the habitual diet can significantly increase consumer plasma and platelet LC n-3 PUFA status. As a result, red meat from grass-fed animals may contribute to dietary intakes of LC n-3 PUFA in populations where red meat is habitually consumed.

Effects of supplementation with fish oil and barium selenate on performance, carcass characteristics and muscle fatty acid composition of late season lamb finished on grass-based or concentrate-based diets.

The objectives of this study were to investigate the effects of fish oil supplementation on performance and muscle fatty acid composition of hill lambs finished on grass-based or concentrate-based diets, and to examine the interaction with selenium (Se) status. In September 2006, 180 entire male lambs of mixed breeds were sourced from six hill farms after weaning and finished on five dietary treatments: grazed grass (GG), grass +0.4 kg/day cereal-based concentrate (GC), grass +0.4 kg/day cereal-based concentrate enriched with fish oil (GF), ad libitum cereal-based concentrate (HC) and ad libitum fish oil-enriched concentrate (HF). Within each treatment, half of the lambs were also supplemented with barium selenate by subcutaneous injection. At the start of the trial, the proportion of lambs with a marginal (<0.76 µmol/l) or deficient (<0.38 µmol/l) plasma Se status was 0.84 and 0.39, respectively. Compared with control lambs, GG lambs treated with Se had higher (P < 0.01) plasma Se levels, whereas erythrocyte glutathione peroxidase activity was higher (P < 0.01) for Se-supplemented lambs fed diets GG and GF. However, Se supplementation had no effects on any aspect of animal performance. Fish oil increased (P < 0.05) levels of 22:5n-3 and 22:6n-3 in the Longissimus dorsi of HF lambs but otherwise had no effect on the health attributes of lamb meat. There were no significant effects of fish oil on dry matter intake, animal performance or lamb carcass characteristics. Daily carcass weight gain (CWG; P < 0.001), carcass weight (P < 0.01) and conformation score (P < 0.01) increased with increasing concentrate inputs. Lambs fed concentrate-based diets achieved a higher mean CWG (P < 0.001), dressing proportion (P < 0.001) and carcass weight (P < 0.011), and were slaughtered up to 8.3 days earlier (P < 0.05) and at 1.2 kg lower (P < 0.05) live weight than pasture-fed lambs. However, carcasses from grass-fed lambs contained lower levels of perinephric and retroperitoneal fat (P < 0.05), and had less fat over the Iliocostalis thoracis (P < 0.001) and Obliquus internus abdominis (P < 0.05). Meat from grass-fed lambs also had lower levels of 18:2n-6 and total n-6 fatty acids compared with those finished indoors. The results of this study demonstrate that fish oil supplementation has some benefits for the health attributes of meat from lambs fed concentrate-based diets but not grass-based diets. Supplementing Se-deficient lambs with barium selenate will improve Se status of lambs fed zero-concentrate diets, but has no additional benefit when lambs are already consuming their daily Se requirement from concentrates or when fish oil-enriched diets are fed.

Does ultrasound correlate with surgical or histologic findings in greater trochanteric pain syndrome? A pilot study.

BACKGROUND: Greater trochanteric pain syndrome can be severely debilitating. Ideal imaging modalities are not established, treatments are not reliably evaluated, and the underlying pathology is not well understood. QUESTIONS/PURPOSES: Using surgical and histopathology findings as a gold standard, we therefore determined the positive predictive value of preoperative ultrasound assessment for greater trochanteric pain syndrome recalcitrant to nonoperative management. In addition, we report the outcomes of gluteal tendon reconstructive surgery using validated clinical and functional outcome tools and evaluate the contribution of the tendon and bursa to greater trochanteric pain syndrome. PATIENTS AND METHODS: We reviewed 24 patients who had combined gluteal tendon reconstruction and bursectomy. Preoperative ultrasound imaging was compared with surgical findings. In the absence of a greater trochanteric pain syndrome specific outcome tool, surgical outcomes for pain and function were assessed via a 100-mm visual analog scale, the modified Harris hip score, and the Oswestry Disability Index. Strength also was measured. The tendon and bursa tissue collected at surgery was histopathologically reviewed. RESULTS: In our small study, ultrasound had a high positive predictive value for gluteal tendon tears (positive predictive value = 1.0). Patients reported high levels of pain relief and function after surgery; tendon and bursa showed pathologic changes. CONCLUSIONS: Ultrasound appears to be clinically useful in greater trochanteric pain syndrome; reconstructive surgery seems to relieve pain and the histopathologic findings show tendinopathy and bursa pathology coexist in greater trochanteric pain syndrome. LEVEL OF EVIDENCE: Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.

Multivariate prediction of clarified butter composition using Raman spectroscopy.

Raman spectroscopy has been used to predict the abundance of the FA in clarified butterfat that was obtained from dairy cows fed a range of levels of rapeseed oil in their diet. Partial least squares regression of the Raman spectra against FA compositions obtained by GC showed good prediction for the five major (abundance >5%) FA with R2 = 0.74-0.92 and a root mean SE of prediction (RMSEP) that was 5-7% of the mean. In general, the prediction accuracy fell with decreasing abundance in the sample, but the RMSEP was <10% for all but one of the 10 FA present at levels >1.25%. The Raman method has the best prediction ability for unsaturated FA (R2 = 0.85-0.92), and in particular trans unsaturated FA (best-predicted FA was 18:1 t delta9). This enhancement was attributed to the isolation of the unsaturated modes from the saturated modes and the significantly higher spectral response of unsaturated bonds compared with saturated bonds. Raman spectra of the melted butter samples could also be used to predict bulk parameters calculated from standard analyzes, such as iodine value (R2 = 0.80) and solid fat content at low temperature (R2 = 0.87). For solid fat contents determined at higher temperatures, the prediction ability was significantly reduced (R2 = 0.42), and this decrease in performance was attributed to the smaller range of values in solid fat content at the higher temperatures. Finally, although the prediction errors for the abundances of each of the FA in a given sample are much larger with Raman than with full GC analysis, the accuracy is acceptably high for quality control applications. This, combined with the fact that Raman spectra can be obtained with no sample preparation and with 60-s data collection times, means that high-throughput, on-line Raman analysis of butter samples should be possible.