Recurrent and injurious falls are common after hip fracture and are associated with multiple risk factors, many of which are treatable. Interventions should therefore be tailored to alleviating or reversing any nutritional, physiological, and psychosocial risk factors of individual patients.

The aim of this study was to determine whether an exercise program, commencing 4-6 weeks post-operatively, reduces upper limb impairments in women treated for early breast cancer. Women (n = 160) were randomized to either an 8-week exercise program (n = 81) or to a control group (n = 79) following stratification for axillary surgery. The exercise program comprised a weekly session and home program of passive stretching and progressive resistance training for shoulder muscles. The control group attended fortnightly assessments but no exercises were provided. The primary outcome was self-reported arm symptoms derived from the EORTC breast cancer-specific questionnaire (BR23), scored out of 100 with a low score indicative of fewer symptoms. The secondary outcomes included physical measures of shoulder range of motion, strength, and swelling (i.e., lymphedema). Women were assessed immediately following the intervention and at 6 months post-intervention. The change in symptoms from baseline was not significantly different between groups immediately following the intervention or at 6 m post-intervention. The between group difference immediately following the intervention was 4 (95% CI -1 to 9) and 6 months post-intervention was 4 (-2 to 10). However, the change in range of motion for flexion and abduction was significantly greater in the exercise group immediately following the intervention, as was change in shoulder abductor strength. In conclusion, a supervised exercise program provided some, albeit small, additional benefit at 6 months post-intervention to women who had been provided with written information and reminders to use their arm. Both the groups reported few impairments including swelling immediately following the intervention and 6 months post-intervention. Notably, resistance training in the post-operative period did not precipitate lymphedema.

These data indicate that 1) either the nuclear or the DXA method can be applied to estimate SMM in healthy older subjects, and 2) the Norland DXA instrument significantly underestimates FFM in older women, in part, because of the influence of truncal adiposity.

There is a high prevalence and wide spectrum of gastrointestinal symptoms in spinal cord injury. Abdominal bloating and constipation are primarily related to specific spinal cord levels of injury, whereas abdominal pain and fecal incontinence are primarily associated with higher levels of anxiety. Based on our findings, further physiologic and psychologic research studies in spinal cord injury patients should lead to more rational management strategies for the common gastrointestinal symptoms in spinal cord injury.

Assessment of sarcopenia by DXA midthigh slice is a potential low-radiation, accessible alternative to CT scanning of older patients. The errors inherent in this technique indicate, however, that it should be applied to groups of patients rather than to individuals or to evaluate the response to interventions.

Patients with non-diarrhea predominant irritable bowel syndrome with symptoms of pelvic floor dyssynergia exhibit overall pelvic floor dyssynergia physiology similar to that of patients with functional constipation. Certain features, however, such as abnormal balloon expulsion, may be more prominent in the patients with irritable bowel syndrome. Therapeutic modalities, such as biofeedback, that are effective in patients with functional constipation with pelvic floor dyssynergia should therefore be considered in selected patients with irritable bowel syndrome with pelvic floor dyssynergia.

The complex comorbidity, pre-existing functional impairment, and sedentary behavior in patients with hip fracture suggest the need for thorough screening and targeting of potentially reversible impairments. Rehabilitation outcomes are likely to be highly dependent on amelioration of these highly prevalent accompaniments to hip fracture.

The physiological and cognitive performance of acclimatized soldiers undertaking routine patrol and reconnaissance activities in the tropics was investigated. Data were obtained during a patrol and a reconnaissance exercise followed by a short assault. Ambient conditions were characterized by temperatures of 30 to 33 degrees C, low humidity (52-59%), and moderate to high solar radiation. Maximum metabolic rates during patrol were high, although the equipment carried was modest and the terrain was not severe. Rectal temperatures peaked at 38.2 and 38.4 degrees C for patrol and assault activities, respectively; peak heart rates were 160 beats min-1 for each activity. Sweat rates of approximately 9 and 14 g kg-1 body weight h-1 were recorded for patrol and assault activities, respectively. The soldiers maintained adequate hydration levels and displayed no evidence of deterioration in cognitive performance. The data show that routine operational activities in tropical conditions induced physiological strain in acclimatized soldiers. However, this strain was not maintained at hazardous levels for lengthy periods.