Environmental stimulation improves performance in the ox-maze task and recovers Na+,K+-ATPase activity in the hippocampus of hypoxic-ischemic rats

In animal models, environmental enrichment (EE) has been found to be an efficient treatment for alleviating the consequences of neonatal hypoxia-ischemia (HI). However the potential for this therapeutic strategy and the mechanisms involved are not yet clear. The aim of present study is to investigate behavioral performance in the ox-maze test and Na+,K+-ATPase, catalase (CAT) and glutathione peroxidase (GPx) activities in the hippocampus of rats that suffered neonatal HI and were stimulated in an enriched environment. Seven-day-old rats were submitted to the HI procedure and divided into four groups: control maintained in standard environment (CTSE), control submitted to EE (CTEE), HI in standard environment (HISE) and HI in EE (HIEE). Animals were stimulated with EE for 9 weeks (1 h/day for 6 days/week) and then behavioral and biochemical parameters were evaluated. Present results indicate learning and memory in the ox-maze task were impaired in HI rats and this effect was recovered after EE. Hypoxic-ischemic event did not alter the Na+,K+-ATPase activity in the right hippocampus (ipsilateral to arterial occlusion). However, on the contralateral hemisphere, HI caused a decrease in this enzyme activity that was recovered by EE. The activities of GPx and CAT were not changed by HI in any group evaluated. In conclusion, EE was effective in recovering learning and memory impairment in the ox-maze task and Na+,K+-ATPase activity in the hippocampus caused by HI. The present data provide further support for the therapeutic potential of environmental stimulation after neonatal HI in rats.

A randomized trial of physicians and physical therapists as instructors of the musculoskeletal examination

OBJECTIVE

To evaluate the effectiveness of physicians vs physical therapists as instructors of the musculoskeletal examination to second year medical students.

METHODS

A randomized trial conducted over 3 consecutive years in a physical diagnosis course at The University of North Carolina. During the first (baseline) year, medical students received education about the musculoskeletal examination from a lecture and supervision by clinical preceptors. This increased in the second and third (intervention) years where random halves of each class received supplementary clinical instruction which included a structured manual, a videotape, and supervised practice with either general internal medicine physicians or physical therapists. Outcomes were measured from student performance on a practical test of clinical skills, and by written student evaluations of the supplementary instruction.

RESULTS

As measured on the clinical examination, performance during the intervention years improved over that during the baseline year in both intervention groups. Measures of medical students' clinical skills did not correlate with measures of academic aptitude.

CONCLUSIONS

Clinical education about the musculoskeletal examination should be structured and systematic. Medical students prefer clinical education that is active, provides clear directions, and gives them performance feedback.

Exercise programs for patients with post-polio syndrome: a case report

Several authors have reported on post-polio syndrome, indicating a decline in muscle strength in individuals years after the onset of poliomyelitis. These reports include suggestions that strenuous exercise programs are contraindicated and may have deleterious effects for patients with post-polio syndrome. The purpose of this case study was to examine the effects of an aggressive, six-week isokinetic exercise program on a 59-year-old patient with post-polio syndrome. Peak torque values were assessed before and during the exercise program, and 6 and 22 weeks following cessation of the exercise program. The results indicate no deleterious effects secondary to the exercise program. The authors suggest future research strategies to investigate the efficacy of exercise programs for patients with post-polio syndrome.