Objective To assess the impact of daily cane use during gait in relation to pain, function, general health and energy expenditure among patients with knee osteoarthritis. Method Sixty-four patients were randomly assigned to an experimental group (EG) or control group (CG). The EG used a cane every day for 2 months, whereas the CG did not use a cane in this period. The fi rst outcome was pain and the second were function (Lequesne and WOMAC), general health (SF-36) and energy expenditure (gas analysis during the 6-minute walk test (6MWT) with and without a cane). Evaluations were performed at baseline, 30 and 60 days. Results The groups were homogeneous for all parameters at baseline. Compared with the CG, the EG signifi cantly improved pain (ES 0.18), functionLequesne (ES 0.13), some domains of SF-36 (role physical, ES 0.07 and bodily pain, ES 0.08) and distance on the 6MWT with the cane (ES 0.16). At the end of the 6MWT with the cane, the EG signifi cantly improved energy expenditure (ES 0.21), carbon dioxide production (ES 0.12) and metabolic equivalents (ES 0.15) compared with the CG.

The purpose of the present study was to evaluate sleep patterns and complaints, and Periodic Limb Movement (PLM) and the Restless Legs Syndrome (RLS) in subjects with complete spinal cord injury. Volunteers were submitted to two polysomnograms (Oxford Medilog SAC system -EEG, EMG, EOC): (1) basal night, when the volunteer arrived at the Sleep Center, and (2) after a maximal physical test (Cybex Met 300/increase of 12,5 watts/2 min until exhaustion). Eleven volunteers with complete spinal cord injury between T7-T12 were evaluated. Data were analyzed by the paired Student's t test (total sleeping time) and by the Wilcoxon matched paired test (change of sleep stages, number of awakenings during sleep, latency to REM sleep and leg movements -PLM + RLS). Comparison of sleep recordings from the night before with that from the night after (12 h) practice of physical activity, showed a significant reduction in all of the sleep parameters. The results indicate that physical activity improves the sleep patterns of spinal cord injured volunteers. In particular, we noticed that PLM and RLS after physical activity were inhibited during sleep.

The purpose of this study was to evaluate the serum level of serotonin (5-HT) during rest and response to exercise in subjects with spinal cord injury (SCI) with di erent levels of physical activity. Twenty-®ve male subjects with traumatic paraplegia, the neurological levels being between T1 and T12, volunteered for the study. They were divided into two groups matched for age, weight and time since injury, according to the level of physical activity: 14 inactive and 11 subjects regularly involved in sports activity and considered active. They all performed a maximal spiroergometric test with an arm crank ergometer. Two samples of blood were collected for 5-HT determination, during rest (PRE) and immediately after exercise test (POST). Serum 5-HT concentration was measured by high performance liquid chromatography using electrochemical detection (HPLC-ED). The results showed that peak oxygen uptake (V . O 2peak ) was higher in the active group (27.08+2.60 vs 18.89+5.58 mL.kg 71 .min 71 , P50.001). There were no signi®cant di erences between the inactive and active groups for the 5-HT PRE (respectively 176.96 and 193.73 ng.mL 71 , P40.05) or POST values (275.44 vs 311.05 ng.mL 71 , P40.05). Both groups showed an increment in 5-HT after maximal exercise, but only in the active group it reached statistical signi®cance (Wilcoxon test, P50.02). Our results show that chronic paraplegic individuals have normal resting serum serotonin levels and normal response to exercise. The relationship between training status, mood elevation and 5-HT in SCI could not be established in the present study, and further investigation is needed to clarify this issue.