A "specific exercise" treatment approach appears more effective than other commonly prescribed conservative treatment programs in patients with chronically symptomatic spondylolysis or spondylolisthesis.

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he ligamentous spine is known to be unstable at loads far less than that of body weight (21). The neuromuscular system must therefore fulfill the supplementary and adaptive roles of maintaining postural stability while controlling and initiating movement (1 1). The oblique and transverse abdominals, with coactivation of the lumbar multifidus, are muscles considered to provide an important stiffening effect on the lumbar spine, enhancing its dynamic stability (2). The internal o h lique and transversus abdominis m u s cles in particular are known to be primarily active in providing rotational and lateral control to the spine while maintaining levels of intraabdominal pressure and imparting tension to the thoracolumbar fascia (7-93). A number of studies has documented a degree of functional independence between the deep a h dominal muscles (internal oblique and transversus abdominis) and muscles better designed for torque production, such as the rectus abdominis and external oblique, during various ta& (7-9.32).Recent studies indicate that the deep abdominal muscles undergo changes in their functional performance in populations with chronic low hack pain (18.19.23). Furthermore, clinicians and researchers have described the presence of subtle

IntroductionMobilisation of patients in the intensive care unit (ICU) is an area of growing research. Currently, there is little data on baseline mobilisation practises and the barriers to them for patients of all admission diagnoses.MethodsThe objectives of the study were to (1) quantify and benchmark baseline levels of mobilisation in Australian and Scottish ICUs, (2) compare mobilisation practises between Australian and Scottish ICUs and (3) identify barriers to mobilisation in Australian and Scottish ICUs. We conducted a prospective, observational, cohort study with a 4-week inception period. Patients were censored for follow-up upon ICU discharge or after 28 days, whichever occurred first. Patients were included if they were >18 years of age, admitted to an ICU and received mechanical ventilation in the ICU.ResultsTen tertiary ICUs in Australia and nine in Scotland participated in the study. The Australian cohort had a large proportion of patients admitted for cardiothoracic surgery (43.3 %), whereas the Scottish cohort had none. Therefore, comparison analysis was done after exclusion of patients admitted for cardiothoracic surgery. In total, 60.2 % of the 347 patients across 10 Australian ICUs and 40.1 % of the 167 patients across 9 Scottish ICUs mobilised during their ICU stay (p < 0.001). Patients in the Australian cohort were more likely to mobilise than patients in the Scottish cohort (hazard ratio 1.83, 95 % confidence interval 1.38–2.42). However, the percentage of episodes of mobilisation where patients were receiving mechanical ventilation was higher in the Scottish cohort (41.1 % vs 16.3 %, p < 0.001). Sedation was the most commonly reported barrier to mobilisation in both the Australian and Scottish cohorts. Physiological instability and the presence of an endotracheal tube were also frequently reported barriers.ConclusionsThis is the first study to benchmark baseline practise of early mobilisation internationally, and it demonstrates variation in early mobilisation practises between Australia and Scotland.

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This study investigated patterns of abdominal muscle recruitment during the abdominal drawing in manoeuvre in subjects with chronic low back pain (CLBP) and radiological diagnosis of spondylolysis or spondylolisthesis. Data were collected using surface electromyography from 12 physically active subjects with CLBP and 10 controls. The control subjects displayed an ability to preferentially activate internal oblique with minimal activation of upper rectus abdominis during the action of drawing in the abdominal wall. The group with CLBP were unable to achieve this. This finding may reflect the presence of neuromuscular dysfunction in this group. Further study is required to investigate if these findings are linked to the ability of patients with CLBP to provide dynamic stability of their lumbar spine.

A 12-week individualized running training skills intervention results in achievement of running ability goals and participation in the school environment in children with cerebral palsy. Implications for Rehabilitation Children with cerebral palsy who can walk unaided demonstrate impairments in higher level mobility such as running. Running is a motor skill that can be trained in children with cerebral palsy. Individually tailored running skills intervention, delivered in a group context can improve goal-identified running ability and translate into a higher frequency of participation in school activities.