Study Design: A randomized controlled trial, pretest-posttest design, with a 3-, 6-, and 12-month follow-up. Objectives: To investigate the efficacy of a therapeutic exercise approach in a population with chronic low back pain (LBP). Background: Therapeutic approaches developed from the Pilates method are becoming increasingly popular; however, there have been no reports on their efficacy. Methods and Measures: Thirty-nine physically active subjects between 20 and 55 years old with chronic LBP were randomly assigned to 1 of 2 groups. The specific-exercise-training group participated in a 4-week program consisting of training on specialized (Pilates) exercise equipment, while the control group received the usual care, defined as consultation with a physician and other specialists and healthcare professionals, as necessary. Treatment sessions were designed to train the activation of specific muscles thought to stabilize the lumbar-pelvic region. Functional disability outcomes were measured with The Roland Morris Disability Questionnaire (RMQ/RMDQ-HK) and average pain intensity using a 101-point numerical rating scale. Results: There was a significantly lower level of functional disability (P = .023) and average pain intensity (P = .002) in the specific-exercise-training group than in the control group following the treatment intervention period. The posttest adjusted mean in functional disability level in the specific-exercise-training group was 2.0 (95% CI, 1.3 to 2.7) RMQ/RMDQ-HK points compared to a posttest adjusted mean in the control group of 3.2 (95% CI, 2.5 to 4.0) RMQ/RMDQ-HK points. The posttest adjusted mean in pain intensity in the specific-exercise-training group was 18.3 (95% CI, 11.8 to 24.8), as compared to 33.9 (95% CI, 26.9 to 41.0) in the control group. Improved disability scores in the specific-exercise-training group were maintained for up to 12 months following treatment intervention. Conclusions:The individuals in the specific-exercise-training group reported a significant decrease in LBP and disability, which was maintained over a 12-month follow-up period. Kingston, Ontario K7L 3N6, modified Pilates-based approach was more efficacious than usual care in a population with chronic, unresolved LBP.

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The purpose of this study was to investigate the effects of exercise-induced muscle injury on passive and active wrist joint stiffness. Ten male subjects were repeatedly tested over a period of 11 days, once prior to, and four times following a bout of eccentric exercise with the wrist extensor muscles. Static wrist stiffness was measured by applying a 3 degrees ramp and hold displacement of the manipulandum, which stretched the wrist extensor muscles. Wrist extension maximum voluntary contraction (MVC) declined by 24.5% from pre-exercise to 24 h after the exercise bout (P < 0.001). There was a reduced passive range of motion (ROM) from 82.8 degrees pre-exercise to 70.2 degrees on day 1 (P < 0.01), but no change in the passive joint stiffness at the neutral joint position, suggesting mechanical changes in the non-contractile tissues, or swelling that only resisted movement at the extremes of the ROM. Active joint stiffness at 50% pre-exercise MVC declined from 0.299 Nm deg(-1) pre-exercise to 0.254 Nm deg(-1) on day 1 (P < 0.025). Active joint stiffness at 10% pre-exercise MVC did not change on any of the days of testing compared to pre-exercise. These findings may indicate that large muscle fibers were more affected by the injury than small muscle fibers.

In order to determine the maximum joint stiffness that could be produced by cocontraction of wrist flexor and extensor muscles, experiments were conducted in which healthy human subjects stabilized a wrist manipulandum that was made mechanically unstable by using positive position feedback to create a load with the characteristics of a negative spring. To determine a subject's limit of stability, the negative stiffness of the manipulandum was increased by increments until the subject could no longer reliably stabilize the manipulandum in a 1 degree target window. Static wrist stiffness was measured by applying a 3 degree rampand-hold displacement of the manipulandum, which stretched the wrist flexor muscles. As the load stiffness was made more and more negative, subjects responded by increasing the level of cocontraction of flexor and extensor muscles to increase the stiffness of the wrist. The stiffness measured at a subject's limit of stability was taken as the maximum stiffness that the subject could achieve by cocontraction of wrist flexor and extensor muscles. In almost all cases, this value was as large or larger than that measured when the subject was asked to cocontract maximally to stiffen the wrist in the absence of any load. Static wrist stiffness was also measured when subjects reciprocally activated flexor or extensor muscles to hold the manipulandum in the target window against a load generated by a stretched spring. We found a strong linear correlation between wrist stiffness and flexor torque over the range of torques used in this study (20-80% maximal voluntary contraction). The maximum stiffness achieved by cocontraction of wrist flexor and extensor muscles was less than 50% of the maximum value predicted from the joint stiffness measured during matched reciprocal activation of flexor and extensor muscles. EMG recorded from either wrist flexor or extensor muscles during maximal cocontraction confirmed that this reduced stiffness was due to lower levels of activation during cocontraction of flexor and extensor muscles than during reciprocal contraction.

The purpose of this study was to determine the relationships among measures of rowing performance and selected descriptive, field, and laboratory variables. Rowing performance of 20 intercollegiate oarswomen was assessed using a 2,500-m time test on a Concept II rowing ergometer, the rower's competitive experience, and the coach's ranking of the rowers. The oarswomen also underwent standardized descriptive tests including anthropometric measurements, field tests including 90-s rowing ergometer distance and weight lifting tests, and laboratory tests including VO2max and isokinetic knee extensor strength tests. Rowing ergometer times were highly related to competitive experience (rho = -0.86; p < 0.01) and coach's ranking (rho = 0.87; p < 0.01). VO2max was the only other variable to produce correlations greater than 0.71 with rowing performance. Although most of the correlations observed in the present study were poor to modestly high, they do document and quantify relationships, and suggest that training and testing techniques should be modified to be more rowing specific and that their usefulness with respect to positive transfer and prediction should be examined.