Tom Gwinn

Dynamic splints do not reduce contracture following distal radial fracture: a randomised controlled trial

QUESTION Do dynamic splints reduce contracture following distal radial fracture? DESIGN Assessor-blinded, randomised controlled trial. PARTICIPANTS Forty outpatients with contracture following distal radial fracture. INTERVENTION The control group received routine care consisting of exercises and advice for 8 weeks. In addition to routine care, during the day the experimental group received a dynamic splint, which stretched the wrist into extension but allowed intermittent movement. OUTCOME MEASURES The primary outcomes were passive wrist extension and the Patient Rated Hand Wrist Evaluation (PRHWE). The secondary outcomes were active wrist extension, flexion, radial deviation, and ulnar deviation, and the performance and satisfaction items of the Canadian Occupational Performance Measure (COPM). All outcomes were measured at commencement, at the end of 8 weeks of treatment, and at 12 weeks (ie, 1 month follow-up). RESULTS The mean between-group difference for passive wrist extension and PRHWE at 8 weeks were 4 deg (95% CI -4 to 12) and -2 points (95% CI -8 to 4), respectively. The corresponding values at 12 week follow-up were 6 deg (95% CI 1 to 12) and 2 points (95% CI -5 to 9). There were no sufficiently important between-group differences for any of the secondary outcome measures at 8 or 12 weeks. CONCLUSION It is unclear whether dynamic splints following distal radial fracture have therapeutic effects on passive wrist extension or PRHWE, but they clearly do not have any therapeutic effects on active wrist extension, flexion, radial or ulnar deviation, or on the performance or satisfaction items of the COPM. The ongoing use of dynamic splints following distal radial fracture is difficult to justify. TRIAL REGISTRATION ACTRN12608000309381.

The associations between polymorphisms in the CD36 gene, fat oxidation and cardiovascular disease risk factors in a young adult Australian population: A pilot study

Our pilot study in a young adult Australian cohort aimed to investigate potential associations between CD36 polymorphisms (rs1527479 and rs1984112), fat oxidation and cardiovascular disease risk. CD36 genotype was associated with fat oxidation during sub-maximal exercise, resting heart rate and blood pressure, indicating increased chronic disease risk in this otherwise healthy cohort.

Interactions Between Fatty Acid Transport Proteins, Genes that Encode for Them, and Exercise: A Systematic Review

Long‐chain fatty acid (LCFA) movement into skeletal muscle involves a highly mediated process in which lipid rafts are utilized in the cellular membrane, involving numerous putative plasma membrane‐associated LCFA transport proteins. The process of LCFA uptake and oxidation is of particular metabolic significance both at rest and during light to moderate exercise. A comprehensive systematic search of electronic databases was conducted to investigate whether exercise alters protein and/or gene expression of putative LCFA transport proteins. There were 31 studies meeting all eligibility criteria, of these 13 utilized an acute exercise protocol and 18 examined chronic exercise adaptations. Seventeen involved a study design incorporating an exercise stimulus, while the remaining 14 incorporated a combined exercise and diet stimulus. Divergent data relating to acute exercise, as well as prolonged exercise training (≥3 weeks), on protein content (PC) response was identified for proteins CD36, FABPpm and CAV1. Messenger ribonucleic acid (mRNA) data did not always correspond to functional PC, supporting previous suggestions of a disconnect due to potentially limiting factors post gene expression. The large array of study designs, cohorts, and primary dependent variables within the studies included in the present review elucidate the complexity of the interaction between exercise and LCFA transport proteins. Summary of the results in the present review validate the need for further targeted investigation within this topic, and provide an important information base for such research. J. Cell. Physiol. 231: 1671–1687, 2016.

Cardiorespiratory responses during functional electrical stimulation cycling and electrical stimulation isometric exercise

Study design:Prospective experimental.Objectives:To compare the cardiorespiratory responses with electrical stimulation (ES) producing either dynamic leg cycling or intermittent isometric leg contractions using the same ES protocol.Setting:Sydney, Australia.Methods:Eight paraplegics (T4–T11) performed ES exercise sessions on two separate days. On day 1, cardiorespiratory responses were measured during 5 min of rest followed by 35 min of cycling, and finally 15 min of intermittent isometric exercise using the same ES parameters. On the second day, after 5 min of rest, 35 min of isometric exercise was performed followed by 15 min of cycling.Results:There were no significant differences during the first 35 min of exercise on each day comparing the two modes of exercise for average rate of oxygen consumption (cycling, 534±128 ml min−1; isometric 558±146 ml min−1; P=0.451), the average heart rate (cycling, 93±15 b.p.m.; isometric 95±17 b.p.m.; P=0.264) or minute ventilation (cycling, 23.0±6.5 l min−1; isometric 23.8±6.7 l min−1; P=0.655). In addition, there were no significant differences between exercise modes for any peak cardiorespiratory values recorded during the initial 35 min of exercise or the following 15 min crossover exercise phase.Conclusion:The current data found that intermittent ES leg isometric exercise elicited a similar cardiorespiratory response compared with functional ES leg cycling, suggesting it should be investigated as a viable alternative intervention for increasing whole body metabolic rate during sustained exercise training sessions for individuals with paralyzed muscles.

Associations between CD36 gene polymorphisms, fat tolerance and oral fat preference in a young-adult population.

Background/Objectives:CD36 is known to be an orosensory receptor for dietary long-chain fatty acids, as well as being involved in the chemosensory mechanisms within the human gut. Recent data have demonstrated an association between CD36 single-nucleotide polymorphisms (SNPs) and lipid consumption behaviours in humans. This study aimed to test for associations between CD36 SNPs and response to a high-fat meal in a young healthy Australian cohort. Secondary associations were tested between CD36 gene variants and fasting lipid parameters, body composition, cardiovascular disease (CVD) risk factors and measures of oral fat preference.Subjects/Methods:Two SNPs (rs1527479 and rs1984112) were assessed for associations with response to a 75 g saturated fat oral fat tolerance test (OFTT), whole-body substrate oxidation, fasting plasma lipids, CVD risk factors and self-reported habitual diet questionnaires. Genotyping was performed using real-time polymerase chain reaction.Results:Cross-sectional data were collected on 56 individuals (28 m, 28 f; 24.9±3.3 years), with 42 completing participation in a high-fat OFTT. No genotypic associations were evident in anthropometric data or self-reported fat preference measures. AA SNP carriers at rs1984112 exhibited significantly elevated fasting triglyceride when compared with non-carriers (P=0.024). This group also tended to have an elevated response to a high-fat meal (P=0.078).Conclusions:Although these data show the potential pleiotropic influence of CD36 SNP rs1984112 on lipoprotein accumulation in a young healthy cohort, further assessment in a larger cohort is warranted.