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Matt S. Stock and Brennan J. Thompson

We examined the means, medians, and variability for motor-unit interpulse intervals (IPIs) during voluntary, high force contractions. Eight men (mean age = 22 years) attempted to perform isometric contractions at 90% of their maximal voluntary contraction force while bipolar surface electromyographic (EMG) signals were detected from the vastus lateralis and vastus medialis muscles. Surface EMG signal decomposition was used to determine the recruitment thresholds and IPIs of motor units that demonstrated accuracy levels ≥ 96.0%. Motor units with high recruitment thresholds demonstrated longer mean IPIs, but the coefficients of variation were similar across all recruitment thresholds. Polynomial regression analyses indicated that for both muscles, the relationship between the means and standard deviations of the IPIs was linear. The majority of IPI histograms were positively skewed. Although low-threshold motor units were associated with shorter IPIs, the variability among motor units with differing recruitment thresholds was comparable.

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Jacinto Javier Martínez-Payá, José Ríos-Díaz, María Elena del Baño-Aledo, David García-Martínez, Ana de Groot-Ferrando and Javier Meroño-Gallut

The objective of this observational cross-sectional study was to investigate the normal motion of the median nerve when stretched during a neurodynamic exercise. In recent years, ultrasonography has been increasingly accepted as an imaging technique for examining peripheral nerves in vivo, offering a reliable and noninvasive method for a precise evaluation of nerve movement. Transverse motion of the median nerve in the arm during a neurodynamic test was measured. A volunteer sample of 22 healthy subjects (11 women) participated in the study. Nerve displacement and deformation were assessed by dynamic ultrasonography. Excellent interobserver agreement was obtained, with kappa coefficient of .7–.8. Ultrasonography showed no lateral motion during wrist extension in 68% of nerves, while 73% moved dorsally, with statistically significant differences between sexes (ORlat = 6.3; 95% CI = 1.4–27.7 and ORdor = 8.3; 95% CI = 1.6–44.6). The cross-sectional area was significantly greater in men (3.6 mm2). Quantitative analysis revealed no other statistically significant differences. Our results provide evidence of substantial individual differences in median nerve transverse displacement in response to a neurodynamic exercise.

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Jeff A. Nessler, Tomas Gonzales, Eric Rhoden, Matthew Steinbrick and Charles J. De Leone

The purpose of this study was to examine the effects of interpersonal synchronization of stepping on stride interval dynamics during over-ground walking. Twenty-seven footswitch instrumented subjects walked under three conditions: independent (SOLO), alongside a partner (PAIRED), and side by side with intentional synchronization (FORCED). A subset of subjects also synchronized stepping to a metronome (MET). Stride time power spectral density and detrended fluctuation analysis revealed that the rate of autocorrelation decay in stride time was similar for both the SOLO and PAIRED conditions, but was significantly reduced during the FORCED and MET conditions (p=0.03 & 0.002). Stride time variability was also significantly increased for the FORCED and MET conditions (p<0.001). These data suggest that forced synchronization of stepping results in altered stride interval dynamics, likely through increased active control by the CNS. Passive side by side stepping, where synchronization is subconscious, does not appreciably alter stepping in this manner.

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Melissa Jack, Ryan Tierney, Jamie Mansell and Anne Russ

Focused Clinical Question: In patients with myofascial trigger point pain, does dry needling result in greater decreases in pain compared to sham needling? Clinical Bottom Line: The evidence supporting dry needling as more effective than sham needling in reducing patients’ pain is mixed.

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Joanne E. Folker, Bruce E. Murdoch, Louise M. Cahill, Kristin M. Rosen, Martin B. Delatycki, Louise A. Corben and Adam P. Vogel

Electropalatography (EPG) was used to describe the pattern of linguopalatal contact and the consonant phase durations exhibited by a group of seven individuals with dysarthria associated with Friedreich’s ataxia (FRDA). A group of 14 non-neurologically impaired individuals served as controls. The Reading Electropalatograph (EPG3) system was used to record linguopalatal contact during production of the target consonants (/t/, /l/, /s/, /k/) elicited in five words of CV and CVC construction, with the target consonants in word initial position. These words were embedded into short sentences and repeated five times by each participant. The FRDA group exhibited significantly increased consonant durations compared with the controls while maintaining normal linguopalatal contact patterns. These findings suggest that the articulatory impairment in FRDA manifests as a temporal rather than spatial disturbance.

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Mindi Fisher, Ryan Tierney, Anne Russ and Jamie Mansell

Clinical Question: In concussed patients, will having attention deficit hyperactivity disorder (ADHD) or learning difficulties (LD) versus not having ADHD or LD cause higher symptom severity scores or invalid baseline protocols? Clinical Bottom Line: Research supports the concept that there is a difference at baseline for individuals with ADHD and/or LD compared with those who do not.

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Tessa Gordon, Esther Udina, Valerie M.K. Verge and Elena I. Posse de Chaves

Injured peripheral but not central nerves regenerate their axons but functional recovery is often poor. We demonstrate that prolonged periods of axon separation from targets and Schwann cell denervation eliminate regenerative capacity in the peripheral nervous system (PNS). A substantial delay of 4 weeks for all regenerating axons to cross a site of repair of sectioned nerve contributes to the long period of separation. Findings that 1h 20Hz bipolar electrical stimulation accelerates axon outgrowth across the repair site and the downstream reinnervation of denervated muscles in rats and human patients, provides a new and exciting method to improve functional recovery after nerve injuries. Drugs that elevate neuronal cAMP and activate PKA promote axon outgrowth in vivo and in vitro, mimicking the electrical stimulation effect. Rapid expression of neurotrophic factors and their receptors and then of growth associated proteins thereafter via cAMP, is the likely mechanism by which electrical stimulation accelerates axon outgrowth from the site of injury in both peripheral and central nervous systems.

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Francesca Wightman, Suzanne Delves, Caroline M. Alexander and Paul H. Strutton

Descending bilateral control of external oblique (EO) and latissimus dorsi (LD) was investigated using transcranial magnetic stimulation. Contralateral (CL) motor evoked potential (MEP) thresholds were lower and latencies were shorter than for ipsilateral (IL) MEPs. Hotspots for EO were symmetrical; this was not the case for LD. The volumes of drive to the left and right muscles were not different. The laterality index was not different between the left and right muscles. The average index for the EO muscles was closer to zero than that for LD, suggesting a stronger IL drive to EO. The symmetry of drive to each muscle did not differ; however, the symmetry of drive varies within a subject for different muscles and between subjects for the same muscle. The findings may be useful in understanding a number of clinical conditions relating to the trunk and also for predicting the outcome of rehabilitative strategies.

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Andrzej Kochanowicz, Bartłomiej Niespodziński, Jan Mieszkowski, Stanisław Sawczyn, Paweł Cięszczyk and Kazimierz Kochanowicz

Purpose: To determine neuromuscular and torque kinetic changes after 10 months of explosive sport training in the elbow of prepubertal gymnasts compared with untrained age-matched controls. Methods: In 15 young gymnasts (9.02 [0.41] y) and 15 age-matched untrained males (8.76 [0.51] y), the rate of torque development (RTD) using the Biodex System 4 and the coactivation index were evaluated using electromyography. Explosive strength variables were normalized to the peak torque. Measures were determined twice: before and after a 10-month period of gymnastic training. Covariation analysis was used to account for differences in baseline values between gymnasts and controls. Results: After 10 months of training, gymnasts demonstrated a significantly (P < .05) greater increase in normalized peak RTD values in elbow flexion compared with controls (7.76% vs 0.65%). Covariation analysis also revealed a significantly (P < .05) greater reduction in the coactivation index of elbow extension in the gymnasts (−7.81% [5.44%] points) compared with controls (−1.23% [6.32%] points). Conclusions: Compared with physical development alone, 10 months of explosive-strength training of young gymnasts is sufficient to increase torque-normalized RTD in the elbow joint of prepubertal boys. The RTD changes the authors observed in antagonistic elbow functions vary among gymnasts due to the specific demands of gymnastic training.

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Neil Maguire, Paul Chesterton and Cormac Ryan

that a 70-minute PNE session for undergraduate physiotherapy students improved pain neurophysiology knowledge, improved attitudes, and increased the likelihood of delivering appropriate treatment recommendations to patients with chronic pain. Given the prevalence of low back pain in the athletic