We studied the effect of smoking on energy expenditure in eight healthy cigarette smokers who spent 24 hours in a metabolic chamber on two occasions, once without smoking and once while smoking 24 cigarettes per day. Diet and physical exercise (30 minutes of treadmill walking) were standardized on both occasions. Physical activity in the chamber was measured by use of a radar system. Smoking caused an increase in total 24-hour energy expenditure (from a mean value [+/- SEM] of 2230 +/- 115 to 2445 +/- 120 kcal per 24 hours; P less than 0.001), although no changes were observed in physical activity or mean basal metabolic rate (1545 +/- 80 vs. 1570 +/- 70 kcal per 24 hours). During the smoking period, the mean diurnal urinary excretion of norepinephrine (+/- SEM) increased from 1.25 +/- 0.14 to 1.82 +/- 0.28 micrograms per hour (P less than 0.025), and mean nocturnal excretion increased from 0.73 +/- 0.07 to 0.91 +/- 0.08 micrograms per hour (P less than 0.001). These short-term observations demonstrate that cigarette smoking increases 24-hour energy expenditure by approximately 10 percent, and that this effect may be mediated in part by the sympathetic nervous system. The findings also indicate that energy expenditure can be expected to decrease when people stop smoking, thereby favoring the gain in body weight that often accompanies the cessation of smoking.

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The Pursuit of Virtù is a personal narrative revisiting a pivotal riding lesson that unlocked the uglier side of the adage that the horse is a mirror to your soul. The beating heart of the essay reflects on how a rider’s trauma can manifest in the body of the horse as well as how classical dressage—the pursuit of courage and collection—can provide a map to return to a harmonious state of balance that is as much mental as physical. Mostly, it is a prayer asking forgiveness from all horses who have had to carry the unbearable burden of human hearts and minds heavier than their bodies could ever be.

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Background: A subgroup of low back pain (LBP) patients present with movement control impairment (MCI). Although there has been extensive research in this area, there is a lack of knowledge of how movement control develops over time and the factors that impact MCI after an acute LBP-episode. Objective : The investigation followed the time-course of MCI in the first three months after an onset of acute LBP-episode, including a baseline-effect evaluation of various demographic, physical and psychosocial characteristics on MCI. Methods : Within this prospective cohort study, 68 subjects with an acute onset of LBP of less than four weeks duration were recruited. In conclusion, 56 subjects were assessed three times at four, eight and twelve weeks. Questionnaire data was collected using an online survey, including demographic data, pain intensity, recurrence of LBP, disability, depression, pain-related activity patterns, activity level and the use of physiotherapy treatment. In addition, a physical examination was performed at the same time points (TP) to assess MCI. For the data analysis, we performed a regression analysis, using proportional odds models. Results : The majority of the participants presented with MCI during the measurement period, although with highly individual courses. The evaluation of baseline and time effects for disability, pain-related activity patterns and physical treatment confirmed interactions with MCI. In contrast, pain intensity and recurrent episodes of LBP revealed effects on MCI only in the adjusted model in combination with other variables. Conclusions : MCI plays a significant role in a subgroup of subjects in the course of LBP after an acute onset of symptoms. Physiotherapy treatment showed short time effects on MCI and might be essential in stratified care in a primary care setting. Further longitudinal studies are needed to assess the association of those different physical and psychosocial characteristics of MCI to calculate their time-interaction on MCI. This is due to the multidimensional nature of LBP and the underlying mechanisms of MCI still being unidentified.