Environmental stimulation improves performance in the ox-maze task and recovers Na+,K+-ATPase activity in the hippocampus of hypoxic-ischemic rats.

In animal models, environmental enrichment (EE) has been found to be an efficient treatment for alleviating the consequences of neonatal hypoxia-ischemia (HI). However the potential for this therapeutic strategy and the mechanisms involved are not yet clear. The aim of present study is to investigate behavioral performance in the ox-maze test and Na+,K+-ATPase, catalase (CAT) and glutathione peroxidase (GPx) activities in the hippocampus of rats that suffered neonatal HI and were stimulated in an enriched environment. Seven-day-old rats were submitted to the HI procedure and divided into four groups: control maintained in standard environment (CTSE), control submitted to EE (CTEE), HI in standard environment (HISE) and HI in EE (HIEE). Animals were stimulated with EE for 9 weeks (1 h/day for 6 days/week) and then behavioral and biochemical parameters were evaluated. Present results indicate learning and memory in the ox-maze task were impaired in HI rats and this effect was recovered after EE. Hypoxic-ischemic event did not alter the Na+,K+-ATPase activity in the right hippocampus (ipsilateral to arterial occlusion). However, on the contralateral hemisphere, HI caused a decrease in this enzyme activity that was recovered by EE. The activities of GPx and CAT were not changed by HI in any group evaluated. In conclusion, EE was effective in recovering learning and memory impairment in the ox-maze task and Na+,K+-ATPase activity in the hippocampus caused by HI. The present data provide further support for the therapeutic potential of environmental stimulation after neonatal HI in rats.

A randomized trial of physicians and physical therapists as instructors of the musculoskeletal examination.

OBJECTIVE: To evaluate the effectiveness of physicians vs physical therapists as instructors of the musculoskeletal examination to second year medical students. METHODS: A randomized trial conducted over 3 consecutive years in a physical diagnosis course at The University of North Carolina. During the first (baseline) year, medical students received education about the musculoskeletal examination from a lecture and supervision by clinical preceptors. This increased in the second and third (intervention) years where random halves of each class received supplementary clinical instruction which included a structured manual, a videotape, and supervised practice with either general internal medicine physicians or physical therapists. Outcomes were measured from student performance on a practical test of clinical skills, and by written student evaluations of the supplementary instruction. RESULTS: As measured on the clinical examination, performance during the intervention years improved over that during the baseline year in both intervention groups. Measures of medical students' clinical skills did not correlate with measures of academic aptitude. CONCLUSIONS: Clinical education about the musculoskeletal examination should be structured and systematic. Medical students prefer clinical education that is active, provides clear directions, and gives them performance feedback.

Consultative and educational roles of a physical therapist in a family practice residency.

Many medical schools and primary care residencies provide little formal instruction in musculoskeletal examination skills. Physical therapists are well qualified by knowledge and experience to teach these skills to students and residents. The authors present educational objectives that have been utilized since May 1988 in the physical therapy teaching portion of a sports medicine rotation in a family practice residency, and they describe the educational and consultative roles of a physical therapist in the residency. The therapist demonstrated the portion of the musculoskeletal examination that is important for the differentiation of contractile and inert tissue involvement, and she reviewed problems unique to athletes. The therapist's presence exposed students, residents, and faculty to the appropriate use of physical therapists as consultants and clinicians.

Method for quantifying assessment of contact thermography: effect of extremity dominance on temperature distribution patterns.

This research was supported in part by a Junior Faculty Research Grant from the Department of Medical Allied Health Professions, The University of North Carolina at Chapel Hill. Chapel Hill. NC. The purposes of this project were to evaluate the reliability of a method for quantitative assessment of contact thermograms; and to test the null hypotheses of no difference in temperature distribution patterns between dominant and nondominant patellar tendon sites and between dominant and nondominant common wrist extensor tendon sites. Both tendon sites were evaluated for 17 normal subjects using contact thermography. A mean temperature was calculated over each tendon site in each subject. Inter-rater reliability for eight pairs of mean temperature calculations by two investigators was r = 0.88. Paired t-tests indicated no statistically significant difference (alpha = 0.05) between dominant and nondominant extremities for either of the tendon sites. The method of thermogram analysis presented in this paper can be used reliably to quantify the assessment of contact thermograms. Clinicians who detect temperature asymmetry at either of the two tendon sites analyzed should attribute this asymmetry to unilateral pathology and not to differences in temperature distribution caused by dominance. J Orthop Sports Phys Ther 1989;10(10):412-417.

Exercise programs for patients with post-polio syndrome: a case report.

Several authors have reported on post-polio syndrome, indicating a decline in muscle strength in individuals years after the onset of poliomyelitis. These reports include suggestions that strenuous exercise programs are contraindicated and may have deleterious effects for patients with post-polio syndrome. The purpose of this case study was to examine the effects of an aggressive, six-week isokinetic exercise program on a 59-year-old patient with post-polio syndrome. Peak torque values were assessed before and during the exercise program, and 6 and 22 weeks following cessation of the exercise program. The results indicate no deleterious effects secondary to the exercise program. The authors suggest future research strategies to investigate the efficacy of exercise programs for patients with post-polio syndrome.