Australian researchers have discovered an entirely new aspect of human muscle behaviour which has implications for treating stroke and multiple sclerosis. Professor Simon Gandevia, of Neuroscience Research Australia and the University of New South Wales, and colleagues, report their findings in the Journal of Physiology. Gandevia and team have discovered that when human muscles are completely relaxed, the muscle fibres don't just shorten, but behave like springs that resist joint motion. Although this sounds paradoxical, it means that at rest, muscles are under no tension whatsoever. "Just imagine a coil of rope or wire that had become so low in tension [or slack] that it buckled," says Gandevia.
In this study, ultrasound was used to image human calf muscles while muscle length was changed by rotating the ankle of relaxed subjects. The muscles of some subjects buckled at short lengths. At short lengths most muscle fascicles (bundles of muscle cells) are slack. As the muscle is lengthened the slack is progressively taken up, first in some fascicles then in others. The increase in muscle length is due partly to increases in the length of muscle fascicles but most of the increase in muscle length occurs in the tendons.
The discovery will allow researchers to build more accurate models of muscle function and improve understanding of disorders where the muscles become really short, says Gandevia, including after a stroke, or in multiple sclerosis, where you can't, for example, straighten out your elbow all the way.
Exercise just as good as drugs at preventing migraines
Although exercise is often prescribed as a treatment for migraine, there has not previously been sufficient scientific evidence that it really works. However, research from the Sahlgrenska Academy at the University of Gothenburg, Sweden, has now shown that exercise is just as good as drugs at preventing migraines. Doctors use a variety of different methods to prevent migraines these days: on the pharmaceutical side a drug based on the substance topiramate has proved effective, while non-medical treatments with well-documented effects include relaxation exercises.
Exercise is also frequently recommended as a treatment, though there has not been sufficient scientific evidence that it really has any effect on migraine patients. In a randomized controlled study researchers from the University of Gothenburg's Sahlgrenska Academy have now analysed how well exercise works as a preventative treatment for migraines relative to relaxation exercises and topiramate.
Published in the journal Cephalalgia, the study involved 91 migraine patients, a third of whom were asked to exercise for 40 minutes three times a week under the supervision of a physiotherapist, with another third doing relaxation exercises, and the final third given topiramate. The study lasted for a total of three months, during which the patients' migraine status, quality of life, aerobic capacity and level of phyical activity were evaluated before, during and after their treatment. Follow-ups were then carried out after three and six months.
The results show that the number of migraines fell in all three groups. Interestingly, there was no difference in the preventative effect between the three treatments. The authors concluded that exercise can act as an alternative to relaxations and topiramate when it comes to preventing migraines, and is particularly appropriate for patients who are unwilling or unable to take preventative medicines.
We discount the pain of people we don't like
If a patient is not likeable, will he or she be taken less seriously when exhibiting or complaining about pain? Reporting in the October 2011 issue of Pain Journal, researchers have found that observers of patients estimate lower pain intensity and are perceptually less sensitive to the patients' pain when the patients are not liked.
40 study participants (17 men and 23 women) were preconditioned by viewing pictures of six different patients tagged with simple descriptions that ranged from negative (egoistic, hypocritical, or arrogant) to neutral (true to tradition, reserved, or conventional) to positive (faithful, honest, or friendly). After this preconditioning process, participants observed short videos of the patients undergoing a standardized physiotherapy assessment. The six patients observed were experiencing shoulder pain and eight short video fragments (2 seconds in duration) of each were selected, resulting in 48 different fragments. After each video fragment, the participants were asked to rate the severity of pain of the patients on a scale of "no pain" to "pain as bad as could be." Afterwards, the participants were also asked to judge the patients to be negative or positive, disagreeable or agreeable, and unsympathetic or sympathetic.
Investigators found that participants rated patients associated with negative traits as less likeable than patients associated with neutral traits. They rated patients associated with neutral traits as less likable than patients associated with positive traits. Further, pain of disliked patients expressing high intensity pain was estimated as less intense than pain of liked patients expressing high intensity pain. Furthermore, observers were less perceptually sensitive toward pain of negatively evaluated patients than to pain of positively evaluated patients, i.e. they were less able to discriminate between different levels of pain expressed by the disliked patients.
Yoga eases back pain in largest US yoga study
Yoga classes were linked to better back-related function and diminished symptoms from chronic low back pain in the largest U.S. randomized controlled trial of yoga to date, published by the Archives of Internal Medicine in October. But so were intensive stretching classes.
"We found yoga classes more effective than a self-care book—but no more effective than stretching classes," said study leader Karen J. Sherman, PhD, MPH, a senior investigator at Group Health Research Institute. Back-related function was better and symptoms were diminished with yoga at 12 weeks; and clinically important benefits, including less use of pain medications, lasted at least six months for both yoga and stretching, with thorough follow-up of more than nine in 10 participants.
In the trial, 228 adults in six cities in western Washington state were randomly assigned to 12 weekly 75-minute classes of either yoga or stretching exercises or a comprehensive self-care book called The Back Pain Helpbook. Nine in 10 of them were primary-care patients at Group Health Cooperative. Participants in the trial typically had moderate—not severe—back pain and relatively good mental health, and most had been at least somewhat active before the trial started.
The class participants received instructional videos and were encouraged to practice at home for 20 minutes a day between their weekly classes. Interviewers who didn't know the patients' treatment assignments assessed their back-related function and pain symptoms at six weeks, 12 weeks, and six months. The type of yoga used in the trial, called viniyoga, adapts the principles of yoga for each individual and physical condition, with modifications for people with physical limitations. The yoga classes also used breathing exercises, with a deep relaxation at the end.
The stretching classes used 15 different stretching exercises, including stretches of the hamstrings and hip flexors and rotators. Each was held for a minute and repeated once, for a total of 52 minutes of stretching. Strengthening exercises were also included.
"We expected back pain to ease more with yoga than with stretching, so our findings surprised us," Dr. Sherman said. "The most straightforward interpretation of our findings would be that yoga's benefits on back function and symptoms were largely physical, due to the stretching and strengthening of muscles."
But the stretching classes included a lot more stretching than in most such classes, with each stretch held for a relatively long time. "People may have actually begun to relax more in the stretching classes than they would in a typical exercise class," she added. "In retrospect, we realized that these stretching classes were a bit more like yoga than a more typical exercise program would be." So the trial might have compared rather similar programs with each other.
Can aromatherapy produce harmful indoor air pollutants?
Spas that offer massage therapy using fragrant essential oils, called aromatherapy, may have elevated levels of potentially harmful indoor air pollutants such as volatile organic compounds (VOCs) and ultrafine particles, according to an article in Environmental Engineering Science, a peer-reviewed journal published by Mary Ann Liebert, Inc.. The article is available free online at www.liebertpub.com/ees
Fragrant essential oils, derived from plants, may release various VOCs into the air. VOC degradation caused by the reaction of these compounds with ozone present in the air can produce small, ultrafine byproducts called secondary organic aerosols (SOAs), which may cause eye and airway irritation.
Taiwanese researchers Der-Jen Hsu (National Kaohsiung First University of Science and Technology), Hsiao-Lin Huang (Chia-Nan University of Pharmacy and Science, Tainan), and Shiann-Cherng Sheu (Chang-Jung Christian University, Tainan) tested both fragrant and Chinese herbal essential oils for SOA formation in a controlled-environment study chamber under different test conditions. They also performed air sampling and analysis in spa centers that offer massage therapy using essential oils.
The authors compared SOA levels associated for the various fragrant and herbal essential oils tested and present their results in the article, "Characteristics of Air Pollutants and Assessment of Potential Exposure in Spa Centers during Aromatherapy." They conclude that the layout and ventilation within a particular spa may affect the level of indoor air pollutants produced during massage with aromatherapy.
"Dr. Der-Jen Hsu and his colleagues have done a very nice job in bringing attention to often overlooked health risks associated with luxuries intended to enhance our sense of well-being," says Domenico Grasso, PhD Editor-in-Chief and Vice President for Research, Dean of the Graduate College, University of Vermont (Burlington).
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