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Imagery can improve functional outcomes post-anterior cruciate ligament repair (ACLR). Research is needed to investigate potential mechanisms for this effect. The aim of this study was to (a) evaluate the effectiveness of an imagery intervention to improve functional outcomes post-ACLR, and (b) explore potential mechanisms. A randomizedcontrolled pilot trial was conducted. Participants were randomized to guided imagery and standard rehabilitation or standard rehabilitation alone (control). The primary outcome was knee strength 6-month post-operatively. Secondary outcomes were knee laxity at 6-months, and change in psychological (self-efficacy) and neurohormonal (adrenaline, noradrenaline, dopamine) variables. Participants (n 5 21; 62% male) were 34.86 (SD 8.84) years. Following the intervention, no statistical differences between groups for knee strength extension at 1801/s (t 5 À 0.43, P 5 0.67), or at 601/s (t 5 À 0.72, P 5 0.48) were found. A statistically significant effect was found for knee laxity, F 5 4.67, Po0.05, mean difference of À 3.02 (95% CI À 4.44 to À 1.60), favoring the intervention. No differences were found for self-efficacy; however, an overall effect was found for noradrenaline, F(1, 19) 19.65, Po0.001, g 2 5 0.52, and dopamine, F(1, 19) 6.23, P 5 0.02, g 2 5 0.29, favoring the intervention. This imagery intervention improved knee laxity and healing-related neurobiological factors.

Introduction-Smoking during pregnancy is common, and quitting at any point during pregnancy can yield benefits to both the fetus and mother. Smoking cessation is typically followed by withdrawal symptoms and a strong desire to smoke, both of which are likely to contribute to relapse. Research has shown that a bout of exercise minimizes cravings and tobacco withdrawal symptoms (TWS) after temporary abstinence in smokers, but these findings have not been replicated in pregnant smokers. This study examined the effect of 20 min of exercise on cravings (primary outcome) and TWS (secondary outcomes) among temporary abstinent, inactive pregnant smokers.Methods-Thirty female smokers (Mean(M) age = 25.7 years, Standard Deviation(SD) = 5.5; M weeks pregnant = 18.2, SD = 5.3; Fagerstrom Test for Cigarette Dependence = 3.3, SD = 2.2; M 9.3 cigarettes/day, SD = 4.7; M hours abstained = 17.2, SD = 2.8) were randomized to 20 min of mild-to-moderate intensity exercise (EC; n = 14) or passive (PC; n = 16) condition. Cravings and TWS were assessed immediately before, during (at 10 min), immediately post, and at 10, 20, and 30 min post-condition.Results-A 2 (condition) × 6 (time) repeated measures ANOVA revealed that the EC significantly (p < 0.05) reduced cravings (ή 2 = 0.46) compared with the PC, across time. Nonsignificant, but nevertheless, large effects were evident favouring the EC over time for TWS ☆ Editorial board for Addictive Behaviors. *Corresponding author at: University of Western Ontario, Faculty of Health Sciences, School of Kinesiology, Thames Hall/3M Centre, London, Ontario, Canada, N6A 3K7. Tel.: +1 519 661 2111x80173. hprapave@uwo.ca (H. Prapavessis). Contributors HP, GF, PS, MM, and MU conceived the study. SDJ, AC, TH and LF recruited participants and conducted the study in London, ON. MU recruited participants and collected the study in London, England. HP and SDJ ran the statistical analyses and prepared the first draft of the manuscript, which were jointly interpreted and edited by the authors, respectively. All authors contributed to and approved the final version of the manuscript. Conflict of interestMy coauthors and I do not have any personal or financial conflicts of interest related to the research, nor do the authors have other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, this work. CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript restlessness (ή 2 = 0.34), stress (ή 2 = 0.24), irritability (ή 2 = 0.21), tension (ή 2 = 0.15), and depression (ή 2 = 0.14).Conclusions-Consistent with previous research, this study reveals that in pregnant smokers, a bout of exercise is associated with a reduction in cravings and similar patterns exist for TWS. Therefore, exercise may have the potential to assist in the initial stages of smoking cessation attempts during pregnancy.

B ackground: Cigarette cravings are one of the most often expressed difficulties related to quitting.The effect of acute exercise on craving and withdrawal symptoms during a pharmacological based smoking cessation intervention is unknown. Methods: Participants included female smokers (n = 178) undertaking the Getting Physical on Cigarettes trial -a 14-week exercise-aided nicotine replacement therapy (NRT, i.e. patch) cessation program. They completed the Shiffman-Jarvik scale immediately before and after the first scheduled exercise session during weeks 5, 11, and 13. The first exercise session (week 5) occurred shortly after participants quit smoking (week 4) and began their 21 mg NRT patch dose. The second and third exercise bout coincided soon after participants stepped down their NRT strength to 14 mg (week 11) and 7 mg (week 13), respectively. Results: Significant reductions in cigarette craving were demonstrated following exercise at all three time points (i.e. week 5, 11, and 13). Significant reductions in psychological and sedation withdrawal symptoms were shown at week 5 and 11, but not at week 13. Significant increases in physical symptoms were found at week 5 and 11, but not week 13. No significant change in appetite was evident at any time point. Conclusions: An acute bout of moderate intensity exercise can alleviate cravings as well as psychological and sedation withdrawal symptoms in quitters during a 14-week exercise-aided NRT smoking cessation program. Promoting exercise among women using NRT is recommended.

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